<prompt> In a chronic smoker a highly malignant aggressive and metastatic lung carcinoma isSmall cell carcinomaSquamous cell carcinomaLarge cell carcinomaAdenocarcinoma  <response>: Cigarette smoking is most strongly associated with squamous cell carcinoma and small cell carcinoma. Small cell carcinoma variant is more malignant and metasizes Ref Harrison 19th edition pg 1702 