What is the Straight Dope on smoking?

I know it is bad for you. But with all the hysteria it is hard to evaluate the actual risk. If you listen to the propaganda you would think that if you ever saw a pack of cigarettes you are going to die of cancer. In reality people used to smoke a LOT but many seem to have lived beyond forty.

The General Question is what is the realistic risk for a smoker? Does a smoker in Alaska have a greater risk of developing cancer or emphysema than say a non-smoker in smog filled LA?

Can we rise above the hype and get a straight answer?


Note that this is only for people under the age of 65 (and is data from 1984 when smoking habits, etc. might have been different.) But, if you’re a white male, then it’s probably around 5 years of life on average.

No idea on smog. But I’ve certainly never seen smog listed as a top item on preventable years of potential life lost (YPLL) charts. The big three, if I recall correctly, are obesity, smoking, and drunk drivers.

The American Cancer Society [pdf] has a very good report. Scroll to page 34 where it states that smoking can be attributed to 30 percent of all cancer deaths and 87 percent of all lung cancer deaths.

OK, but what is the prevalence of lung cancer? In other words 87% of what?

Some dudes have survived being shot - several times in fact. Does that mean “that it isn’t so risky”?

Even if you don’t die from lung cancer, there is little doubt smoking still cuts years (maybe even decades) off your life. And, you even appear to age faster.

So, let us assume you are one of the lucky ones that gets not a whiff of cancer. Still, at 55 you feel, act, look and have the health of a 65yo, +/-.

Then there’s other lung and heart disease problems caused by smoking but not associated with cancer.


So a male smoker has about a 1 in 6 chances of getting lung cancer where his chances would have been about 1 in 77 had he not smoked. Considering that getting lung cancer never ends up being a small deal and pairing that with all the other serious health risks associated with smoking (possibly killing him before he got a chance to get lung cancer), it doesn’t seem the perceived dangers of smoking are based on hysteria or propaganda.

For a definitive answer (or at least as definitive as epidimological studies get) you should turn to my favorite medical journal, the CDC’s Morbidity and Mortality Weekly Report. Here is the Annual Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses — United States, 1997–2001–look at the numbers for yourself.

In regard to lung cancer and emphysemas that are not traceable to toxic chemical exposure, the rate is so low–even in heavily air polluted regions–that smoking is clearly the common and highly correlative factor for cancer and emphysemas in smokers. Aside from the effects of the known carcinogens in tobacco (and particularly in the highly processed tobacco used in commerical cigarettes) smoking deposits tars and harmful ashes that interfere with gas exchange and other respiratory processes, and also introduces a very toxic alkali (nicotine) to the bloodstream. Call up your local hospital or morgue and ask them if you can come down and take a look at the inside of a long-term smoker’s lung in comparison to a healthy lung, and you’ll see exactly what smoking does to your insides. Remember that nasty yellow tar that used to coat the inside of every office building and had to be removed with industrial solvent? That stuff is being concentrated on the inside of the lung.

The other correlated health issues with smoking (greater incidence of respiratory infection, decreased fertility, decreased capillary function, increased blood pressure and risk of heart disease, exacerbation of other chronic health conditions) are all well documented in the above links and elsewhere. The the chronic health effects of smoking (as with excessive alcohol consumption, high fat diet, et cetera) are long-term and generally start manifesting at about age 50…by which time it is generally too late to mitigate those effects. Of course, smoking also has its benefits, like a perilously small reduction in rate of endometrial cancer, and that charming smoker’s hacking laugh cum choking cough, but the negatives vastly outweigh any benefits.

Wanna smoke? Be my guest, as long as you do it away from my stool. But don’t deceive yourself or anyone else that it’s not a manifestly unhealthy activity with a vast array of clinical evidence as to the harm that it does.


I recently read (but have no cite) that it takes 20 pack-years to significantly increase your odds of getting cancer.

That means 20 yrs at a pack a day - 10 years at 2 packs a day - 40 years at 1/2 a pack a day…

That certainly doesn’t mean that you can’t get cancer from smoking after 5 yrs or that you are ever guaranteed to get cancer from smoking. That’s just a statistical average.

I think such a statement is richly deserving of a cite.

The risks of smoking may be dose dependent, but it certainly takes much fewer than 20 pack-years to reach a, “significant,” increase in smoking risk.

Yes, and if you are an obese smoker who drives drunk, like my old friend Mike, you’re on very thin ice. Mike, rest his soul, died at 49 of a stroke. He was awaiting trial on a DUI charge when he died. :frowning:

“Pack-years”? Wouldn’t that just be measured in “packs”, then?

20 years * 1 pack/day * 365.25 days/year = 7305 packs.

I guess it’s easier to say 20 pack years than 7305 packs? I’m just relaying what I heard

I know it was my statement and therefore the burden of proof is on me. But do you have a cite saying that it “certainly takes fewer than 20 pack-years”? Not that I’ll fault you if you don’t. I’m just asking why you believe that.

FTR, I’m an ex-smoker who detests cigarettes and everything involved with them. I have no hidden agenda to try to prove that they are less harmful.

Total band name!

Why don’t you want anyone smoking near your stool? :confused:

Or did you mean one of those three-legged things you sit on?

I’d like to see a cite on that as well. I think the claim that brewha was remembering was more like that twenty pack-years correlates to a significantly increased long term risk of chronic illnesses regardless of whether the patient is a current or past smoker. This shouldn’t be inferred to mean that smoking does not have any significant near term effects or an increase in cancer incidence, but after 20 years of smoking one pack a day, quitting smoking has less of an effect on reduction of long term health effects than quitting earlier due to cumulative. (I’m trying to find an on-line reference for this but I’m coming up short; just a few JSTOR and other subscription only papers.) “Pack-years” is also a somewhat vague qualitative estimation that is good for large groups where the average rate of consumption is somewhere around one pack a day, but is not a particularly useful number in determining individual risk, especially in relation to occasional or heavy smoking, or other existing aggravating factors.

Like all epistemological studies, the attempt to isolate the effect of one factor is confounded by the huge number of uncontrolled variables, and so without a specific causal chain that allows a “closed form” evaluation of the likelyhood of the influence of a particular effect, researchers have to wade though a haystack of data in the hope of finding a few needles. In the case of smoking, however, the correlation to health impacts is so dramatic–that is, the difference in health problems between a non-smoking population and a population of regular smokers is so different–that the harms of tobacco smoking are an inescapable conclusion.



The major cause of lung cancer is tobacco smoking, reflected by the fact that 80%–90% of lung cancer patients smoke. JNCI: Journal of the National Cancer Institute | Oxford Academic

Although approximately 10% of heavy smokers (with more than 20 pack-years of smoking) develop lung cancer, the percentage of all smokers who develop lung cancer is substantially lower. Check out Table 3 here to see the rate of death from lung cancer for former smokers, current smokers who smoke less than a pack a day, and current smokers who smoke more than a pack a day. JNCI: Journal of the National Cancer Institute | Oxford Academic

Bottom line: The risk of all smoking-related mortality (COPD, cardiac, and lung cancer) begins to rise with just a few cigarettes a day, but the risk really really goes up once one passes the 20 pack-year level, especially as regards the risk of lung cancer. And it takes 20 to 30 years of abstinence from smoking for a 20+ pack-year person to have their cancer risk return to that of an infrequent or “light” smoker.

So there’s no known “safe” dose (especially if one has other risk factors like hypertension, diabetes, or lipid disorders). but if you smoke anyway and you don’t plan to quit, you really really want to stay under the 20 pack-year limit.

Roy Castle, a talented musician, died from lung cancer. which he attributed to years of playing in smoky jazz clubs early in his career.

Another thing to remember is that, even if you suspect that the chances of getting the big diseases (lung cancer, emphysema, COPD come to mind) are inflated by the conventional hype, you have to agree that the odds are not insignificant. And once you do get them, well, it’s most likely going to be a pretty unpleasant way to spend the rest of your life.

I smoked for some years, and even have a doctor friend who basically says if you only smoke a little bit (say a few cigarettes a week or less), you probably have a decent chance of turning out more or less ok. But he would never say this to an actual patient, only to a close friend with whom he likes to be an enabler :wink: I quit anyway after really thinking about it from a risk-analysis point of view.

Only problem is, if I get something bad in my later years anyway, I’m gonna be sore that I missed out on all these years of smoking. Because dear god, I still love it.

On a related note, the chance of stink is very close to 100%.

Hey kids, It’s time for our Video Lesson on tar today! :eek:

Hey, that’s similar to a science fair project I did in junior high school, only I drew the smoke through a coffee filter. After 50 cigarettes the Geiger counter started clicking. Measureable concentrations of lead, radium, and polonium were found in the residue, and these are all cummulative elements in the body (i.e. not readily purged by natural processes).

The amazing thing isn’t that smoking causes health effects, but how long it actually takes to kill you. Note that it’s not only the incidence of lung cancer that increases; several other carcinomas, including breast and prostate cancer, also increase in correlation with smoking, not to mention other health impacts.