JAMA: Low-intensity smokers who puff on 10 or less cigarettes per day over their lifetime still have higher risks of death than individuals who never smoke, providing further evidence that there is no safe level of cigarette smoking, according to a study published online by JAMA Internal Medicine. Tobacco smoking is a public health issue around the world, estimated to cause 5 million deaths annually. However, there are few data on the effects of long-term, low-intensity smoking and a perception among some people that such a level can be safe.
Maki Inoue-Choi, Ph.D., M.S., of the National Cancer Institute,
Rockville, Md., and coauthors examined associations between long-term
smoking of fewer than one or 1 to 10 cigarettes per day with the risk of
death among current and former smokers.
The study included 290,215 older adults (ranging in age from 59 to
82) who completed the 2004-2005 questionnaire in the National Institutes
of Health – AARP Diet and Health Study. The questionnaire assessed
lifetime smoking intensity during previous age periods from less than 15
years old to 70 or more. Among the group, there were 22,337 current
smokers (7.7 percent), 156,405 former smokers (53.9 percent) and 111,473
never smokers (38.4 percent).
Compared with individuals who never smoked, consistently
low-intensity smokers of 10 or less cigarettes per day had a higher risk
of death from all causes and associations were seen across
smoking-related causes of death, especially lung cancer, according to
Former smokers who had been consistently low-intensity smokers had
progressively lower risks of death the younger they were when they quit,
the authors report.
Limitations of the study include its small numbers of low-intensity
smokers. Participants also recalled their smoking intensity after the
“These findings provide further evidence that there is no safe level
of cigarette smoking. All smokers should be targeted for smoking
cessation, regardless of how few cigarettes they smoke per day. Further
studies are needed to examine the health risks of low-intensity
cigarette smoking in combination with electronic nicotine delivery
systems and other tobacco products,” the study concludes.
(JAMA Intern Med. Published online December 5, 2016. doi:10.1001/jamainternmed.2016.7511; available pre-embargo at the For The Media website.)