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National Cancer Institute (NCI) Press Release

Posted: December 5, 2016
Contact: NCI Press Office
(240) 760-6600

No Safe Level of Smoking: Even Low-intensity Smokers Are at Increased Risk of Earlier Death

People who consistently smoked an average of less than one cigarette per day over their lifetimes had a 64% higher risk of earlier death than never smokers, and those who smoked between one and 10 cigarettes a day had an 87% higher risk of earlier death than never smokers, according to researchers at the National Cancer Institute (NCI). Risks were lower among former low-intensity smokers compared to those who were still smokers, and risk fell with earlier age at quitting. The results of the study were reported in the December 5, 2016 issue of JAMA Internal Medicine.

When researchers looked at specific causes of death among study participants, they observed an especially strong association for lung cancer mortality. Those who consistently averaged less than one cigarette per day over their lifetime had 9 times the risk of dying from lung cancer than never smokers. Among people who smoked between one and 10 cigarettes per day, the risk of dying from lung cancer was nearly 12 times higher than that of never smokers.

The researchers looked at risk of death from respiratory disease, such as emphysema, as well as the risk of death from cardiovascular disease. People who smoked between one and 10 cigarettes a day had over 6 times the risk of dying from respiratory diseases than never smokers and about 1-1/2 times the risk of dying of cardiovascular disease than never smokers.

Smoking has many harmful effects on health that have been detailed in numerous studies since the US Surgeon General’s 1964 report linking smoking to lung cancer. The health effects of consistent low-intensity smoking, however, have not been well studied and many smokers believe that low-intensity smoking does not affect their health.

To understand the effects of low-intensity smoking on mortality from all causes and for specific causes of death, the scientists analyzed data on over 290,000 adults. Low-intensity smoking was defined as 10 or fewer cigarettes per day. Participants were between age 59 and 82 at the start of the study.

Participants were asked about their smoking behaviors during 9 periods across their lives, beginning with before they reached age 15 until after they reached age 70 (for the older participants). Among current smokers, 159 reported smoking less than one cigarette per day consistently throughout the years that they smoked; nearly 1500 reported smoking between one and 10 cigarettes per day.

The study relied on people recalling their smoking history over many decades, which introduced a degree of uncertainty into the findings. Also, despite the large number of people surveyed, the number of consistent low-intensity smokers was relatively small.

“The results of this study support health warnings that there is no safe level of exposure to tobacco smoke,” said Maki Inoue-Choi, PhD of the NCI Division of Cancer Epidemiology and Genetics, the lead author of the study. “Together, these findings indicate that smoking, even a small number of cigarettes per day, has substantial negative health effects and provide further evidence that smoking cessation benefits all smokers, regardless of how few cigarettes they smoke.”

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