The health risks of smoking are well known. Smoking is the leading cause of preventable death in Western countries.
Each year, it causes more than 19,000 deaths in Australia alone and contributes to preventable health conditions, including; heart disease, diabetes, stroke, cancer, renal disease, eye disease and respiratory conditions such as asthma, emphysema and bronchitis.
The inhalation of cigarette or tobacco smoke is hazardous. Cigarette smoking risks far exceed the risks for any other type of tobacco. Never using it and avoiding second-hand breathing smoke is the safest way. If tobacco is to be used, cigars, if not inhaled, and some snuff tobaccos carry much less risk.
Main Heath Risks
- Heavy cigarette smoking triples the risk compared with a never smoker of dying early.
- Five to nine cigarettes a day doubles the risk compared to a never smoker dying early.
- Very light smoking still increases the risk of dying early by over half.
- Cigarette smokers mostly inhale, incurring increased risks compared with cigars and pipes.
- Cigar smokers who inhale have chances equal to that of a pack a day cigarette smoking.
- Inhaled second-hand smoke raises the total death risk by 20% – as from living with a smoker.
- Swedish moist snuff (snus) increases the entire death risk by 17% over a never-smoker.
- Cigar smoke, if not inhaled, raises the total death risk by 14% over that of a never-smoker.
- Never smokers who live in a home where no one smokes have the least risk.
- Anyone combining cigarettes with other products will have an intermediate level of risk.
- Nicotine does not add to a person’s risk.
Risk To Health From Smoking Statistics
- The risk of dying early from continuing to smoke cigarettes past 35 years is one in two (those affected lose on average 13 years of life).1
- By age 35, 84% of cigarette smokers say they are addicted.2 This means many would find it challenging to stop smoking.
- Light smoking (5-9 cigarettes a day) doubles the risk of a smoker dying early. (Figure 1)
- Heavy smoking (20+ cigarettes /day) triples the risk.
- The cigarette is the most dangerous tobacco product known and the most popular. Cigarettes, including hand-rolled ones, account for 99% of all tobacco sold in New Zealand.3 Contrast Sweden: 48% cigarettes, 46% snus, 6% cigars, pipes and hand-rolled.4
- Hand-rolled cigarettes are likely to be of at least similar toxicity.
- Beedis (Indian handmade cigarettes) are equally as dangerous as manufactured cigarettes. Both increase the risk of a heart attack four-fold in middle age.5
- The risk from tobacco is much less if smoke is not inhaled. (Example: most cigar and piper smokers, snuff taking.)
What Can Be Done To Combat Smoking Deaths
- Nicotine vape liquids should be legalised, and vaping promoted by the government to switch from tobacco.
- Cigarette prices should be steadily increased. The Royal Australasian College of Physicians recommends a steady annual increase (2 to 5% every year) above inflation. www.racp.edu.au/hpu/policy/tobacco/tobacco_policy.pdf
- Less harmful tobacco products attract less tax to encourage the switch away from combustible tobacco.
- If the ban on the least toxic snuffs is lifted, it will give smokers more options to avoid lung cancer and lung (emphysema).
Does Reducing The Number Of Cigarettes Reduce Risk?
Light cigarette smoking (5-9 cigarettes per day) doubles the risk of dying early than a never smoker. Light smoking is common nowadays, and most cigarette deaths occur among light smokers.
Alternatives to Smoking Tobacco
Public Health England (PHE) estimates that e-cigarettes are around 95% less harmful than smoking.
The risks of snus or cigar smoke in the mouth (not the lungs) are less than the risks of living with a smoker (and inhaling second-hand smoke)
Using nicotine gum for five years is a safe alternative to smoking.
The risks of snuff or even chewing on a lit cigar are much less than the risk of smoking, provided no smoke is inhaled.
The safest thing to do is not to smoke at all.
Sources:
1 .Peto R et al. Mortality from smoking in developed countries. www.ctsu.ox.ac.uk at p.166. Data for the year 2000.
2. National Research Bureau Ltd. Environmental Tobacco smoke study 1996, summary report. Ministry of Health, at p.15..
3. Laugesen M. Manufacturers’ returns to Ministry of Health. Wellington: Ministry of Health, 2003.
4. Fagerstrom K. The Nicotine market: an attempt to estimate the nicotine intake from various sources and the total nicotine consumption in some countries. Nic Tob Res. 2005; 7: 343-50..
5. Pais P, Fay MP, Yusuf S. Increased risk of acute myocardial infarction associated with beedi and cigarette smoking in Indians: final report on tobacco risks from a case control study. Indian Heart J. 2001; 53: 731-5.
6. Cigarette smoking risks :Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day Tobacco Control 2005; 14: 315-20, based on follow-up of 43,000 Norwegians from 1970s to 2002.
7. Cigar smoking risks: Cigars, health effects and trends. Monograph 9, National Cancer Institute USA, 1998, based on follow-up of 1 million US subjects for 12 years, including 22,000 cigar smokers, in Cancer Prevention Study I, 1959-72.
8. Second hand smoke risk: Hill S, Blakely T, Kawachi I, Woodward A. BMJ 2004 988-89 (24 April). Based on fate of never smokers whether living with a smoker or not in 1996 NZ census.
9. Risks of snus Levy DT et al. Cancer Epidemiology, Biomarkers and Prevention 2004; 13: 2035-42.
10. Risks of nicotine gum. Murray RP, et al. Safety of nicotine polacrilex gum used by 3094 participants in the Lung Health Study. Chest 1996; 109: 438-45. Followed for 5 years, compared with 1900 controls. No increase in hospitalisation or mortality in the nicotine gum chewers.
11.Age and the exposure-response relationships between cigarette smoking and premature death in Cancer Prevention Study II. In Smoking and tobacco control monograph 8: Changes in cigarette-related disease risks and their implications for prevention and control (pp. 383-475). Bethesda, MD: National Cancer Institute.
