Asked by Tom, Cleveland
I started smoking socially in high school and still do. How long would it take for someone like me develop lung cancer?
Dr. Otis Brawley
Chief Medical Officer,
American Cancer Society
There have been several questions about smoking recently. I thought your question really important. In answer to it, there is no such thing as a safe amount of cigarette smoking. I urge you to quit. Studies show that it is far easier for a light smoker to quit than someone who smokes a pack and a half or more per day.
Also keep in mind there is no such thing as a safer cigarette. The risk of lung cancer does increase with both the number of cigarettes smoked per day and the number of years a person has smoked. A 35-year-old male who smokes fewer than 25 cigarettes per day is estimated to have a 9% lifetime chance of dying of lung cancer, whereas 25 cigarettes per day or more gives him an 18% lifetime chance of dying of lung cancer. There are some estimates that lifetime risk of lung cancer in a very heavy smoker is about 30% overall, whereas it is 1% or less in nonsmokers. This translates into about a third of very heavy smokers developing lung cancer. Also, 15 to 20 of every 100 patients who have lung cancer are lifelong nonsmokers. Some get it because of secondhand smoke and some get it for unknown reasons.
People who start smoking at younger ages are at higher risk later in life. Lung cancer rates begin increasing in the mid to late 40s and peak in the late 70s. Many people think low tar or filtered cigarettes are safer. The truth is most people will compensate for these cigarettes by inhaling deeper and/or smoking more cigarettes in order to satisfy their need for nicotine.
While you ask about lung cancer, it is important to remember that occasional cigarette use can increase risk of cardiovascular disease dramatically. This is very pertinent, because cigarette smoking kills more people from cardiovascular diseases (heart attack, stroke and peripheral vascular disease) than all cancers combined. It is a common observation that a town that makes smoking in public illegal lowers it heart attack rate within six months. This is primarily because the decrease in secondhand smoke exposure decreases the number of heart attacks in nonsmokers. Just think about the dose of smoke to even a casual smoker over six months compared to a nonsmoker exposed to occasional secondhand smoke.
Cigarette smoking is linked to a number of diseases. Lung cancer is most famously associated, but tobacco smoking causes cancers of the head and neck (mouth, throat, sinuses), esophagus, stomach, kidney, pancreas, bladder, uterine cervix and even certain types of leukemia. Fourteen different cancers in all are caused by smoking. Smoking also causes chronic obstructive pulmonary disease, such as bronchitis and emphysema. It worsens asthma. Smoking is linked to high blood pressure, ulcers, osteoporosis, diabetes and reproductive disorders such as infertility, miscarriage and premature menopause.
There are significant benefits to smoking cessation. Most tobacco-related disease can be prevented if one stops smoking by age 40. Even for older people and for those with tobacco-related disease, there is significant benefit to smoking cessation. Short-term, cessation causes cravings, irritability, insomnia, anxiety, depression, difficulty concentrating and restlessness. Some may have a worsening of the smoker's cough. Long term, many complain of weight gain and increased depression.
Someone who is thinking of quitting should seek counseling from a physician or other experienced health care professional. Nicotine gum, nicotine patches and some other medications can be very helpful with smoking cessation. Counseling through telephone quit lines and internet support groups can also be helpful.
Is secondhand smoke really that risky?
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