What Are the Risks of Smoking - A Reason to Quit Smoking

Risks of Cigarette Smoking

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There are many risks of smoking and the purpose of this page is to outline the specific risks that are associated with smoking.

Smoking kills over 400,000 people a year -- more than one in six people in the United States -- making it more lethal than AIDS, automobile accidents, homicides, suicides, drug overdoses, and fires combined. It is estimated that the U.S. spends an astounding $50 billion each year on smoking-related health costs. Smoking may be even more dangerous now than 30 years ago, most likely because the lower tar and nicotine levels in most cigarette brands cause people to inhale more deeply. In one study only 42% of male lifelong smokers reached the age of 73 compared to 78% of nonsmokers.

People who are exposed to second-hand or side-stream smoke are also at risk. Smoke that is exhaled not only contains the same dangerous contaminants as inhaled smoke, but the exhaled smoke particles are smaller, so that they can reach distant sites in the lungs of involuntary or passive smokers and do great harm.

Does Smoking Affect Blood Pressure?

Smoking a cigarette raises the blood pressure by 5-10 mm Hg for about 30 minutes. If this is combined with drinking a cup of coffee, the effects are bigger and last longer.

Despite this, numerous epidemiological studies have found that people with hypertension are not more likely to be smokers than those with normal blood pressure, and conversely, that smokers are not more likely to be hypertensive than non-smokers. One possible explanation for this might be that smokers tend to weigh less than non-smokers, and that the effects of obesity and smoking on blood pressure cancel each other out. But even when smokers and non-smokers of the same body weight are compared their blood pressures are the same. This is probably because the blood pressure measurements are usually made when people are not smoking. If you smoke a pack a day, it will raise your average daytime pressure by about 5 mm Hg, even though your doctor may not detect this during an office visit.

The important thing about smoking is not what it does to your blood pressure, but that it greatly increases your risk of heart disease.

Other risks associated with smoking?

ATLANTA (CNN) -- Before Dr. Luther L. Terry, then the Surgeon General of the United States, issued his office's first "Report on Smoking and Health" more than 30 years ago, thousands of articles had already been written on the effects of tobacco use on the human body.

Tobacco companies had countered the reports -- which purported to show links between smoking and cancer and other serious diseases -- with denials and competing studies.

So in 1964, Terry and his Advisory Committee on Smoking and Health knew they were stepping into a major pit of controversy when they announced "cigarette smoking is a health hazard of sufficient importance in the United States to warrant appropriate remedial action."

It was America's first widely publicized acknowledgment that smoking cigarettes is a cause of serious diseases.

But the issue wasn't settled in 1964, nor is it settled in 1997, despite literally thousands more studies -- and litigation that has forced at least one tobacco company to admit what some activists say they knew all along: cigarette smoke is hazardous to your health.

More than 30 years -- and more than 20 Surgeon General reports -- later, the issue appears headed for settlement in the courtroom rather than the laboratory.

So what are the risks? Here's what tobacco's critics say:

CANCER

The Centers for Disease Control and Prevention says cigarette smoking is responsible for 151,322 cancer deaths annually in the United States. Most of those -- 116,920 -- are from lung cancer. The CDC says men who smoke are 22 times more likely to die from lung cancer than non-smokers. Women who smoke are 12 times more likely to die from the disease.

Statistical studies have long shown that people who don't smoke live longer than people who do, and scientists have seen statistically the correlation between smoking and incidences of lung cancer since the 1950s.

But a study earlier this year by Gerd Pfeifer of the Beckman Research Institute pinpointed specific carcinogens in cigarette smoke that target parts of a gene already known to be prominent in some cancers.

Pfeifer wrote in Science that cigarette smoke causes changes in the gene p53, which protects against cancer when normal but promotes cancer growth when mutated.

Another study, published by the American Cancer Society, said that low-tar cigarettes offered no relief from the potential of cancer, and in fact were responsible for a type of cancer that reaches deeper into lung tissue.

Other cancers are also affected by cigarette smoke. An American Cancer Society researcher reported earlier this year that smoking increased men's risk of dying of prostate cancer, while other studies have linked tobacco use to increased risk of other cancers, including throat, breast and bowel cancer.

Smoking Related Cancers:

Adult Acute Leukemia
Adult Chronic Leukemia
Cervical Cancer
Esophagus Cancer
Laryngeal Cancer
Lung Cancer
Kidney Cancer
Oropharyngeal Cancer
Pancreas Cancer
Stomach Cancer
Urinary Bladder

CARDIOVASCULAR DISEASES

Smoking also has been linked time and again to cardiovascular diseases. Among these, the biggest killer is heart disease: according to the CDC, smoking triples the risk of dying from heart disease among middle-aged men and women.

Studies also show an increased risk of death from stroke, aneurysms, high blood pressure, and other cardiovascular illnesses.

RESPIRATORY DISEASES

Smoking is cited as a risk for dying of pneumonia, chronic bronchitis, or emphysema. The CDC says people who smoke increase their risk of death from bronchitis and emphysema by nearly 10 times.

OTHER ILLNESSES

A report recently published in the American Journal of Epidemiology suggested that smoking increased the risk of developing non-insulin-dependent diabetes mellitus (NIDDM) by more than three times.

Studies have pointed to smoking as a risk in vision loss among older people, mental impairment later in life, Alzheimer's disease and other forms of dementia.

EFFECT ON PREGNANCY

Pregnant women who smoke can pass nicotine and carbon monoxide to their baby through the placenta. Research indicates this can prevent the baby from getting the oxygen and nutrients it needs to grow -- potentially leading to fetal injury, premature birth, or low birth weight. According to the American Lung Association, smoking during pregnancy accounts for an estimated 20 to 30 percent of low birthweight babies, up to 14 percent of premature deliveries, and about 10 percent of all infant deaths.

A mother who smokes can also pass nicotine to her baby through her breast milk.

SECONDHAND SMOKE

The studies didn't just point to the ill effects of smoking on those who smoke -- non-smokers, too, are apparently affected by the smoke from their friends, family members and strangers who light up in their presence.

A steady stream of reports documented the statistical risks of contracting cancer or suffering from heart disease, even if you've never put a cigarette to your lips.

The American Heart Association last fall released a seven-year study showing that never-smoking spouses of smokers have more than a 20 percent greater chance of death from coronary heart disease than those who have never smoked who live with non-smokers. That study gave more impetus to the drive to make workplaces and other public areas smoke-free.

The effects of smoking are hard on the children of smokers as well, the studies say. Dr. Claude Hanet of the St. Luc University Hospital in Brussels, Belgium, said earlier this year that a baby born to a smoking mother "should be considered an ex-smoker."

Hanet's study cautioned that cigarette smoke was more detrimental with decreasing age.

And a University of Birmingham, England, study, published in the British Journal of Cancer showed a possible link between fathers who smoked and an increased incidence of cancers in their children, while studies in the U.S. showed a possible link between smoking and DNA damage.

ADDICTION

Of all the diseases associated with smoking, addiction is perhaps the one that receives the least attention. But President Clinton declared nicotine an addictive drug last August. In March, the Liggett Group, makers of Chesterfield and Lark brand cigarettes, admitted that cigarettes were addictive and cause cancer and agreed to pay about $750 million total to 22 states that had filed suit to force tobacco companies to pay for Medicaid for smoking-related illnesses.

Scott Harshbarger, the Massachusetts attorney general and president of the National Association of Attorneys General, told reporters that the Liggett deal "will produce information that indicates major tobacco companies were fully aware that the product they were selling is addictive, that the product they were selling had great impact on public health."

Other tobacco companies are clearly none too keen on the Liggett deal. For them, nicotine remains what they call a harmless flavor enhancement.

BENEFITS?

Despite the weight of the data about the ills of tobacco smoke, research also shows some occasional benefit from smoking. Researchers at the Brookhaven National Laboratory in Upton, New York, reported that something in cigarette smoke lowers the levels of an enzyme known as MAO B.

This coincides with an increase in dopamine, known for years to be the brain chemical responsible for part of nicotine's pleasure.

Smokers, say the researchers, may have a lower risk of Parkinson's disease, because the nerve disease is aggravated by shortages of dopamine.

And while smoking may be a cause of dementia, it also could be sharpening the mind. University of California-San Diego researchers presented a study to the Society for Neuroscience earlier this year showing that smoking cigarettes sharpens short-term learning and memory among young people.

Researchers in the study, however, cautioned that such benefits don't outweigh the risks of more serious ailments.

ASHES TO ASHES

According to the CDC, 400,000 Americans die each year because they smoke cigarettes, making it the single most preventable cause of premature death in the United States.

Quitting doesn't necessarily help, according to another University of Birmingham study -- at least not if the smoker waits too long. Stroke risk is high for up to 20 years after a smoker quits, according to that study, published in the Journal of Epidemiology and Community Health.

The CDC says that on average, if you smoke, you will die seven years earlier than if you don't.

What is the human toll of smoking?

Number of deaths per year attributed to tobacco in the United States: 400,000 *.

Number of deaths per hour: 45.

Number of deaths due to:
Cardiovascular disease: Almost 180,000. *
Obstructive lung disease (chronic bronchitis and emphysema: 65,000 *.

Risk for a smoker dying of lung cancer, compared to a never-smoker:
Male: 22 times
Female: 12 times
Number of scientific studies on the health effects of tobacco, approximate: 50,000.

Percentage of United States adults who smoked in 1993: 25 *

Percentage in 1965: 42 *

Number of years of life smoking costs the average smoker: 7 *

Number of identified carcinogens in tobacco smoke: 43

Estimated 1993 health care costs due to smoking, according to Centers for Disease Control and Prevention: total $50 billion. This figure includes:
$26.9 billion for hospital costs
$15.5 billion for doctors
$4.9 billion in nursing home costs
$1.8 billion for prescription drugs
$900 million for home-health care expenditures

Number of times "addiction" is listed on compulsory cigarette warnings (in United States): 0.

Marketing and promotional budget of tobacco companies, (1993): $6 billion.

Number of cigarette advertisements this money bought that mention addiction, habituation, dependence or the difficulty most smokers experience in quitting: 0.

Revenues of the U.S. tobacco companies, 1991: $32 billion *.

Percentage of adult smokers who had tried cigarettes by 18th birthday: 80.

Percentage of smokers age 12 to 17, according to a 1992 Gallup poll, who want to quit: 66.

Percentage of NCAA baseball athletes who use "smokeless tobacco": 57 (source: "The marketing of nicotine addiction).

Other sources
* American Cancer Society fact sheet "Questions About Smoking, Tobacco, and Health ... and the Answers.

** FDA Fact Sheet.

Smoking is a greater cause of death and disability that any single disease, says the World Health Organisation.

According to their figures, it is responsible for approximately 3.5 million deaths worldwide every year - or about 7% of all deaths. Tobacco smoking is a known or probable cause of approximately 25 diseases, and even the WHO says that its impact on world health is not fully assessed.

Heart attack and stroke

UK studies show that smokers in their 30s and 40s are five times more likely to have a heart attack than non-smokers. Tobacco contributes to the hardening of the arteries, which can then become blocked and starve the heart of bloodflow, causing the attack. Often, smokers who develop this will require complex and risky heart bypass surgery. If you smoke for a lifetime, there is a 50% chance that your eventual death will be smoking-related - half of all these deaths will be in middle age. Smoking also increases the risk of having a stroke.

Lung problems

Another primary health risk associated with smoking are lung cancer, which kills more than 20,000 people in the UK every year. US studies have shown that men who smoke increase their chances of dying from the disease by more than 22 times. Women who smoke increase this risk by nearly 12 times. Lung cancer is a difficult cancer to treat - long term survival rates are poor. Smoking also increases the risk of oral, uterine, liver, kidney, bladder, stomach, and cervical cancers, and leukaemia. Another health problem associated with tobacco is emphysema, which, when combined with chronic bronchitis, produces chronic obstructive pulmonary disease. The lung damage which causes emphysema is irreversible, and makes it extremely difficult to breathe.

Harm to children

Smoking in pregnancy greatly increases the risk of miscarriage, is associated with lower birthweight babies, and inhibited child development. Smoking by parents following the birth is linked to sudden infant death syndrome, or cot death, and higher rates of infant respiratory illness, such as bronchitis, colds, and pneumonia. Nicotine, an ingredient of tobacco, is listed as an addictive substance by the US authorities. Although the health risks of smoking are culmulative, giving up can yield health benefits regardless of the age of the patient, or the length of time they have been smoking.

Future impact

By 2020, the WHO expects the worldwide death toll to reach 10 million, causing 17.7% of all deaths in developed countries. There are believed to be 1.1 billion smokers in the world, 800,000 of them in developing countries.

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