NEWS BRIEF: Snuffing out the deadly misconceptions about smoking

We have a ways to go before all doctors routinely ask their patients about important lifestyle factors like sugar intake, sleep habits, or even exercise routines. But there’s not a practicing physician out there who will neglect to ask about your smoking status. Because cigarettes kill—and everybody knows it.

Or at least, we assume they do. Which is what makes the results of the following study more than a little concerning…

According to recent findings from researchers at Duke, the number of Americans who consider a pack-a-day habit to be a serious health risk dropped by one percent between 2006 and 2015.1 That might not sound like a big deal. But to put it in perspective, that’s roughly three million people who have decided that smoking isn’t that big of a deal.

To make matters worse, the number of people who responded that smoking a pack or more per day poses “no risk at all” jumped by a full percentage point over the last ten years. (Hard to believe—but those are the facts.)

Fortunately, this change in perception hasn’t resulted in an uptick in the number of smokers—yet. According to the CDC, the number of smokers in the U.S. population dropped from 21 percent to 15 percent in the same time frame. (Still too high, if you ask me.)

What’s worrisome is that this careless shift in attitude can result in more people smoking even the occasional cigarette under the delusion that it’s safe. If that’s the case, then we’ve got a very big problem on our hands.

Because the truth is, one cigarette could still kill you.

Even the occasional puff sends your stroke risk soaring

Consider the results of a recent meta-analysis featured in the British Medical Journal. It used data from nearly 150 studies to assess the dangers of light smoking. (In other words, the kind of habit a lot of patients might not even bother to report to their doctor.)

And its findings tell a shocking story.

Researchers had predicted that smoking a single cigarette daily would carry only a five percent cardiovascular risk associated with a pack-a-day habit. But their results showed that, in reality, just one cigarette accounts for a whopping 46 percent of the coronary heart disease risk smoking poses to men. And 31 percent of the risk to women.2

For smoking-related stroke risk, the news was just as bad—with just one cigarette per day carrying 41 percent of the risk for men, and 34 percent of the risk for women.

And let’s be clear—the risk of a single cigarette is only this low compared to a pack-a-day habit. If you want the really ugly truth, just look at how it stacks up to never smoking at all.

When the researchers did that, they found that one daily cigarette was linked with up to a 74 percent spike in heart disease risk for men, and 119 percent for women. In contrast, smoking 20 cigarettes per day—that’s a full pack—increased heart disease risk by as much as 127 percent in men, and a jaw-dropping 295 percent in women.

So it’s true that a cigarette now and then may not be quite as dangerous as smoking them by the pack—especially for women. But there’s absolutely nothing “safe” about it. And the risk to your health is huge, no matter how many you smoke.

This makes any lost ground in the war on tobacco that much more concerning. Cigarettes are as dangerous now as they’ve ever been. And as a society, we just can’t afford to let anyone forget it.

The jury is still out on vaping and e-cigarettes. (Although preliminary evidence isn’t exactly reassuring. But that’s a conversation for another day.) In the meantime, if it’s not clear by now, it should be: The only safe choice is not to smoke at all.


  1. Pacek LR, et al. Drug Alcohol Depend. 2018 Apr 1;185:406-410.
  2. Hackshaw A, et al. BMJ. 2018 Jan 24;360:j5855.