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Why Social Smoking is Still Smoking

John Bankston John Bankston August 21, 2020
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen
Additions/comments by Pulmonologist Kelly Fan, MD

People often lie when they call themselves “non-smokers.” They don’t mean to; just a few cigarettes a day isn’t really smoking, right? Smoking occasionally at bars and nightclubs shouldn’t count. Except to doctors and scientists, nonsmoking means no cigarettes. Ever.

 

It’s understandable. People self-report as nonsmokers because those few cigarettes might mean increased insurance premiums. So what are the risks of light smoking, and are there any benefits?

 

Still Smokin’

 

The Mad Men era where executives chain smoked in their office is long over. It’s not just that workplace smoking is banned. Depending on where in the world you live, it can be illegal to smoke in bars, public parks, on beaches –– even in your own home. These prohibitions combined with billions of dollars in public health advertising has helped reduce smoking rates. When Mad Men took place, over 40% of all adults smoked. Fifty years later, fewer than 15% smoke every day or most days. While this is still more than 38 million Americans, it’s a huge decline. Although the number of smokers tops one billion worldwide, this number has also dropped exponentially.

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Heart Attack: Risk Factors

Heart Attack: Risk Factors

Yet across the world, tobacco use remains the single largest preventable cause of death. One reason is that many people counted as nonsmokers are actually smoking –– just not as much. Tapering off used to be the first step on the road to quitting. Now smoking less than one pack a week is a lifestyle. Smoking less than five cigarettes a day is on the rise. It’s not just the quantity that separates light smokers from heavy users of tobacco. The demographics are drastically different as well. In the 1960s, smokers were often affluent or at least middle class. Today heavy smokers are predominantly low income. Most did not attend college. Yet college students are often light smokers, often while binge drinking. So are the more affluent. Young women increasingly smoke a few cigarettes a day, often for weight control. The problem is that even light smoking increases your risk for developing heart disease and numerous cancers.

 

Where there’s smoke…there’s heart disease

 

Over twenty-five percent of smokers fall into the “light” category of less than five cigarettes a day. Others are intermittent smokers, only smoking when they are doing social activities. In general, smoking less is better than smoking a lot, except when it comes to heart disease. Researchers discovered that the risk for cardiovascular disease when people are light and intermittent smokers is only slightly better than for heavy smokers. This includes the risk for premature death from heart disease and aortic aneurysms, along with high blood pressure and cholesterol-clogged arteries. Although lung cancer rates are more closely linked to how many cigarettes a person smokes, light smokers still have an elevated risk. They are also at risk for premature death overall and have shorter lifespans than nonsmokers.

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Stroke: Modifiable Risk Factors

Stroke: Modifiable Risk Factors

It’s not all bad news. Smokers have a lower likelihood of developing Parkinson disease. And those who smoke for weight control aren’t completely wrong. Although doing one unhealthy thing to prevent another seems illogical, smokers are less likely to be obese. In fact, studies have linked rising rates of obesity to dropping rates of smoking. Still, if you want to call yourself a nonsmoker you might want to put down that cigarette first.

Kelly Fan, MD

Even small amounts of cigarette smoking can lead to acute and chronic problems. Acute eosinophilic pneumonia is a condition seen in younger patients often requiring ICU level care that can be precipitated by starting smoking. Just 100 cigarettes smoked in a lifetime can predispose certain patients to COPD and lung cancer.
Doctor Profile

John Bankston

Author

John Bankston is a published author of over 150 nonfiction books for children and young adults including biographies of Jonas Salk, Gerhard Domak, and Frederick Banting.

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