Health consequences of smoking 1–4 cigarettes per day

Abstract

Objectives: To determine the risk in men and women smoking 1-4 cigarettes per day of dying from specified smoking related diseases and from any cause. Design: Prospective study. Setting: Oslo city and three counties in Norway. Participants: 23 521 men and 19 201 women, aged 35-49 years, screened for cardiovascular disease risk factors in the mid 1970s and followed throughout 2002. Outcomes: Absolute mortality and relative risks adjusted for confounding variables, of dying from ischaemic heart disease, all cancer, lung cancer, and from all causes. Results: Adjusted relative risk (95% confidence interval) in smokers of 1-4 cigarettes per day, with never smokers as reference, of dying from ischaemic heart disease was 2.74 (2.07 to 3.61) in men and 2.94 (1.75 to 4.95) in women. The corresponding figures for all cancer were 1.08 (0.78 to 1.49) and 1.14 (0.84 to 1.55), for lung cancer 2.79 (0.94 to 8.28) and 5.03 (1.81 to 13.98), and for any cause 1.57 (1.33 to 1.85) and 1.47 (1.19 to 1.82). Conclusions: In both sexes, smoking 1-4 cigarettes per day was associated with a significantly higher risk of dying from ischaemic heart disease and from all causes, and from lung cancer in women. Smoking control policymakers and health educators should emphasise more strongly that light smokers also endanger their health. Is there a threshold value for daily cigarette consumption that must be exceeded before serious health consequences occur? Numerous population studies have reported on a strong dose-response relationship between cigarette consumption and severe diseases. In most studies, however, the lowest consumption group was set at 1-9 or 1-15 cigarettes per day. One may argue that smokers in these groups clustered close to the upper limit of this consumption span, and that a threshold value might be found on a lower level.Only a few prospective studies have reported on the health consequences of smoking fewer than five cigarettes per day. [1][2][3] Our aim was to determine the risk in men and women smoking 1-4 cigarettes per day of dying from specified smoking related diseases and from any cause. We report on a Norwegian population of 23 521 men and 19 201 women, aged 35-49 years, who in the mid 1970s were screened for cardiovascular disease risk factors and followed throughout 2002 for deaths from ischaemic heart disease, all cancer, lung cancer, and from all causes. METHODS ParticipantsFrom 1972 to 1978 screening examinations for cardiovascular disease were undertaken in the Norwegian capital, Oslo, and in three Norwegian counties with a mainly rural settlement. In Oslo, all male residents aged 40-49 years were invited, and a 7% random sample of male residents aged 20-39. 4 In the counties, all male and female residents aged 35-49 years were invited, and a 10% random sample of all residents aged 20-34. 5The screening programmes in the four areas included a questionnaire related to cardiovascular diseases. Height, weight, and blood pressure were measured according to an identical protocol. A non-fasting blood sample was dr...

Association of nicotine metabolism and sex with relapse following varenicline and nicotine replacement therapy.

“…Both thresholds gave essentially similar results. It should be mentioned that reduction in CPD consumption (instead of cessation) does not cancel health risks: a significantly higher risk of dying, especially from ischaemic heart disease and lung cancer, was observed in men and women smoking 1 to 4 cigarettes per day compared to never-smokers (Bjartveit & Tverdal, 2005). Thus, changes in CO and cotinine plasma levels consistently showed smaller reduction than CPD (Stead & Lancaster, 2007) due to the phenomenon of oversmoking: smokers involuntarily increase the number and depth of inhalations from the remaining cigarettes to obtain the necessary nicotine quantity (Sadowski, Clair, & Cornuz, 2015).…”

The natural history of light smokers: A population-based cohort study

“…However, light smoking, generally defi ned as smoking no more than 10 CPD, still increases cardiovascular morbidity and mortality as well as all-cause mortality ( Bjartveit & Tverdal, 2005 ;Kawachi et al, 1994 ;Luoto, Uutela, & Puska, 2000 ;Okuyemi et al, 2002 ;Prescott, Scharling, Osler, & Schnohr, 2002 ;Rosengren, Wilhelmsen, & Wedel, 1992 ), even at very low levels of cigarette smoking (e.g., ≤ 5 CPD or smoking less than daily; Bjartveit & Tverdal, 200 5;Kawachi et al, 1994 ;Rosengren et al, 1992 ). These health implications underscore the importance of understanding the pattern and natural history of light smoking, particularly because light smoking is common among young smokers, whose smoking patterns may still be developing ( Biener & Albers, 2004 ;Shiffman, Kassel, Paty, Gnys, & ZettlerSegal, 1994 ;USDHHS, 1994 ).…”

Arsenic Speciation and Cadmium Determination in Tobacco Leaves, Ash and Smoke

“…Although tobacco is not a component of the diet, tobacco smoke is inhaled into the lungs and causes some severe effects on human health, including carcinogenesis. [1][2][3] An accurate assessment of the health hazards of smoking and an associated safety evaluation are necessary for the maintenance of public health, and the above risk assessments would require chemical analysis of tobacco products including smoke. In addition to the human health aspects, evaluations of commercial crops, such as tobacco leaves, might yield information on concerning possible pollution of the agricultural production system.…”