Light Smoking -- Unsafe in Any Dose
June 20, 2012
By Harvey B. Simon, M.D.
The dangers of smoking are well known. It is a major cause of:
Over the years, scientists have discovered that filtered cigarettes, low-tar and nicotine cigarettes, pipes, cigars, smokeless tobacco and secondhand smoke are also major health hazards.
The landmark U.S. Surgeon General's report on Smoking and Health blew the whistle on cigarettes in 1964. Since then, the percentage of Americans who smoke has been cut in half. Yet smoking is still a huge problem.
Why? Nicotine is highly addictive and despite many restrictions, tobacco companies continue to push their products.
And in a curious way, doctors may have contributed to persistent tobacco use by encouraging the belief that light smoking is safe, or at least not that harmful.
A recent study shatters that illusion.
To evaluate the effects of light smoking, researchers from the University of California, San Francisco reviewed over 800 published studies of smoking in adults age 18 and older. They homed in on 45 studies that met tough standards for scientific excellence. Although the individual studies used different criteria for light and intermittent ("social") smoking, each carefully looked at the health risks of low-dose cigarettes.
The results are startling and convincing. All in all, light and intermittent smoking is nearly as dangerous as heavy smoking. When compared with non-smokers:
People who smoke up to 14 cigarettes a day have:
People who smoke up to 9 cigarettes a day have:
People who smoke up to 4 cigarettes a day have:
Men who smoke even occasionally have an overall death rate that is 1.6 times higher than the death rate of non-smokers.
There is no safe dose of smoking. It's up to each smoker to decide to quit. And it's up to his doctor to provide whatever help it takes. And it's up to all of us to encourage everyone to quit and to encourage community standards, legislation and peer pressure that will put smoking in its proper place in the history books. The only safe cigarette is one that's never been smoked.
Avoiding tobacco in all its forms may sound like an easy solution. However, quitting is hard. Most men start out by trying to quit on their own. Here are some tips that can help.
Don't think you have to do this alone. Professional counseling and support groups can help. Your doctor, hospital or local chapter of the American Cancer Society or American Lung Association can put you in touch with programs in your community.
Nicotine replacement therapy can help you break the addiction. Nicotine gum, patches and inhalers are available over the counter; nicotine lozenges are available by prescription. And prescription drugs such as bupropion (Zyban, Wellbutrin) and varenicline (Chantix) can also help. As with all medications, they can have side effects, so ask your doctor if they are right for you.
Schane et al. "Health effects of light and intermittent smoking." Circulation. 2010; 121:1518.
Harvey B. Simon, M.D. is an Associate Professor of Medicine at Harvard Medical School and a member of the Health Sciences Technology Faculty at Massachusetts Institute of Technology. He is the founding editor of the Harvard Men's Health Watch newsletter and author of six consumer health books, including The Harvard Medical School Guide to Men's Health (Simon and Schuster, 2002) and The No Sweat Exercise Plan, Lose Weight, Get Healthy and Live Longer (McGraw-Hill, 2006). Dr. Simon practices at the Massachusetts General Hospital; he received the London Prize for Excellence in Teaching from Harvard and MIT.