EndSmoking NZ - Cigarette Smoking Risks

EndSmoking NZ

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Updated 18 July 2006 . To print, click on www.endsmoking.org.nz/cigaretterisk.pdf

Cigarette smoking risks

CIGARETTE SMOKING RISKS ARE EXTREME

Summary

· Risk of dying early from continuing to smoke cigarettes past 35 years of age is one in two (those affected losing on average 13 years of life).¹

· By age 35, 84% of cigarette smokers say they are addicted.² This means many would find it difficult to stop smoking.

· Light smoking (5-9 cigarettes a day) doubles the risk of a smoker dying early. (Figure 1)

· Heavy smoking (20+ cigarettes /day) triples the risk.

· The cigarette is the most dangerous tobacco product known, and the most popular. Cigarettes, including hand-rolled, account for 99% of all tobacco sold in New Zealand.³ Contrast Sweden: 48% cigarettes, 46% snus, 6% cigars, pipes and hand rolled.⁴

· Hand rolled cigarettes are likely to be of at least similar toxicity.

· Beedis (Indian hand made cigarettes) are equally as dangerous as manufactured cigarettes. Both increase the risk of heart attack four fold in middle age.⁵

· Risk from tobacco is much less if smoke is not inhaled. (Example: most cigar and piper smokers, snuff taking.)

Health risks vary by tobacco product

Cigarette smoking risks far exceed any other type of tobacco. Never using it and seldom breathing second hand smoke is the safest way. In between are products of varying grades of risk. (Figure 1)

· Heavy cigarette smoking triples the risk of a never smoker of dying early.⁶

· Moderate or light cigarette smoking doubles the risk of a never smoker of dying early.⁶

· Very light smoking still increases the risk of dying early by half.⁶

· Cigar smoke inhaled into the lungs – increases the risk as for light cigarette smoking.⁷

· Inhaled second hand smoke is next most dangerous – as from living with a smoker.⁸

· Cigar smoke, (most do not inhale) if not inhaled, raise total death risk by 15% over that of a never-smoker.⁷

· Swedish moist snuff (snus) raises total death risk by 12% over than of a never-smoker.⁹

· Never smokers who live in a home where no-one smokes have the least risk.

· Anyone combining cigarettes with other products will have an intermediate level of risk.

· Nicotine does not add to a person’s risk.¹⁰

HEALTH RISKS VARY BY TOBACCO PRODUCT

Figure 1. Relative mortality risk from smoking, inhaling, snuffing, or abstaining from tobacco

Figure 1. Relative mortality risk from smoking, inhaling, snuffing, or abstaining from tobacco

Sources:

1 .Peto R et al. Mortality from smoking in developed countries. www.ctsu.ox.ac.uk at p.166. Data for the year 2000.

2. National Research Bureau Ltd. Environmental Tobacco smoke study 1996, summary report. Ministry of Health, at p.15..

3. Laugesen M. Manufacturers’ returns to Ministry of Health. Wellington: Ministry of Health, 2003.

4. Fagerstrom K. The Nicotine market: an attempt to estimate the nicotine intake from various sources and the total nicotine consumption in some countries. Nic Tob Res. 2005; 7: 343-50..

5. Pais P, Fay MP, Yusuf S. Increased risk of acute myocardial infarction associated with beedi and cigarette smoking in Indians: final report on tobacco risks from a case control study. Indian Heart J. 2001; 53: 731-5.

6. Cigarette smoking risks :Bjartveit K, Tverdal A. Health consequences of smoking 1-4 cigarettes per day Tobacco Control 2005; 14: 315-20, based on follow-up of 43,000 Norwegians from 1970s to 2002.

7. Cigar smoking risks: Cigars, health effects and trends. Monograph 9, National Cancer Institute USA, 1998, based on follow-up of 1 million US subjects for 12 years, including 22,000 cigar smokers, in Cancer Prevention Study I, 1959-72.

8. Second hand smoke risk: Hill S, Blakely T, Kawachi I, Woodward A. BMJ 2004 988-89 (24 April). Based on fate of never smokers whether living with a smoker or not in 1996 NZ census.

9. Risks of snus Levy DT et al. Cancer Epidemiology, Biomarkers and Prevention 2004; 13: 2035-42.

10. Risks of nicotine gum. Murray RP, et al. Safety of nicotine polacrilex gum used by 3094 participants in the Lung Health Study. Chest 1996; 109: 438-45. Followed for 5 years, compared with 1900 controls. No increase in hospitalization or mortality in the nicotine gum chewers.

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CONCLUSIONS WHAT CAN BE DONE

· Cigarettes are far more dangerous than any other tobacco product.

· Light cigarette smoking (5-9 cigarettes per day) doubles the risk of dying early, compared with a never smoker. Light smoking being common nowadays, most cigarette deaths occur among light smokers.

· The risks of snus or cigar smoke in the mouth (not the lungs) are less than the risks of living with a smoker (and inhaling second hand smoke)

· The risks of snuff or even chewing on a lit cigar are much less than the risk of smoking, provided no smoke is inhaled.

· The safest thing to do is to not smoke at all.

· Using nicotine gum for 5 years is a safe alternative to smoking.

The Minister of Finance can encourage the switch away from cigarettes by

· levying excise according to the risk from using each type of tobacco product.

· Steadily raising the tax on cigarettes, particularly on hand rolled cigarettes. The Royal Australasian College of Physicians recommends a steady annual increase (of 2 to 5 percent every year) above the level of inflation. www.racp.edu.au/hpu/policy/tobacco/tobacco_policy.pdf

· Lifting the ban on the sale of low risk oral snuffs will enable smokers to avoid lung cancer and smokers’ lung (emphysema)

Government needs to regulate cigarette manufacture to require charcoal filtering of toxicants in cigarette smoke. This may reduce the amount of poisonous gases inhaled by some smokers. See www.smokeless.org.nz/lesstoxic.htm However no one can claim that such filters reduce the risk of early death.