Your Weekly Checkup: Smoking Is Even Worse for You Than You Thought

We’ve known for a long time that smoking is bad for you. A new study shows just how bad.


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“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive. 

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I smoked cigarettes for about two years during college and medical school (1960-62) but quit after I attended the autopsy of a smoker who died from cancer of the lung. It was gruesome. I smoked a pipe for another 4 or 5 years and then quit, smoking nothing for the last 50+ years.

A recent study has confirmed the wisdom of stopping smoking. This National Longitudinal Mortality Study (NLMS) followed 357,420 participants from 1985 to 2011. It showed that cigar, pipe, and cigarette use significantly elevated the risk of tobacco-related cancer mortality, as well mortality from most other examined causes of death. Mortality was higher even among nondaily current cigarette users. While increased mortality from cigarette smoking is well known, NLMS established that cigar and pipe smokers were also vulnerable, though the mortality risks for daily pipe and cigar smokers were lower than for daily cigarette smokers.

Sadly, use of combustible tobacco products, including cigars, pipes, and cigarettes, continues to represent the leading cause of preventable deaths in the United States. Most smokers become addicted during their youth. In 2014, the Surgeon General estimated that cigarette smoking caused approximately 480,000 deaths annually.

The Food and Drug Administration, recognizing the addicting power of nicotine, hopes to reduce the number of U.S. smoking deaths by proposing a limit of 0.4 milligrams of nicotine per gram of tobacco, about a 97 percent reduction from present levels. Using simulation models, experts estimated this would cause approximately 5 million smokers to quit in the year after policy implementation. That number would increase to 13 million within five years and would continue to grow because of sustained increases in cessation and decreases in smoking initiation. Unpredictable consequences include whether smokers would smoke more to compensate for the loss of nicotine, would seek other sources of nicotine, and whether black market high-nicotine cigarettes would appear.

The take home message is obvious: quit smoking, whether it is a cigarette, cigar, or pipe. It may be the toughest battle you’ll ever fight, but the rewards are well worth it. And don’t resort to e-cigarettes. More about them next week.

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  1. Really Dr. Zipes, the proposed limit of 0.4 milligrams should have been proposed and implemented decades ago. Better late than never, the decreases in the number of smokers would continue for those really determined to quit.

    Unfortunately, a black market such as you mention will almost surely surface as nicotine equivalents of Monster, Throttle, Rock Star and their horrifying caffeine outer limits will be in demand.

    Personally I’m sensitive to caffeine, but a 12 oz. bottle of Mexican Coke occasionally is still okay. Nicotine is something else. It smells like poison, and I get a skipped heart beat with very little exposure. I had to drop off paperwork at a mental health facility, and nearly all the patients were smoking, right outside the entrance, of course. In their other hand was a Monster or whatever. There’s some kind of stimulation/addiction connection with caffeine and nicotine that go together.

    I don’t mind the smell/scent of pot and don’t have an adverse reaction. Still, I doubt if it’s healthy to be breathing in either. I knew a girl in the mid-80’s who used a bong, big time after work to get high while I just sat there drinking a pop wine.

    She had lines of speed on that table along with her gin & tonic. One day her Dad came by wanting to visit. Joanne just shouted “Daddy, I don’t want you coming in here because you’re not going to like what you see!” Yeah, no kidding—-or smell! Somehow I got a real kick out of her today’s me would not. My suit jacket would still smell of cigarette smoke in the workplace the next day in 1986 before it was banned.


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