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Smoking: the health risks

no-smoking-sign-23-04-12Stub it out. If you puff like a chimney and think you are getting away with it – you’re not. Even the occasional cigarette can kill. We look at the health risks.

Lung cancer

The most common cause of cancer deaths in the UK, lung cancer accounts for more than one in five fatalities. Ninety per cent of lung cancer cases are due to smoking. One in 10 moderate smokers and almost one in five heavy smokers will die of lung cancer.

The more cigarettes you smoke in a day, and the longer you’ve smoked, the higher your risk of lung cancer. Similarly, the risk rises the deeper you inhale and the earlier in life you started smoking.


● Having a cough most of the time
● A change in a cough you have hadfor a long time
● Being short of breath
● Coughing up phlegm that has signs of blood in it
● An ache or pain when breathing and coughing
● Loss of appetite
● Fatigue
● Weight loss
● Having a chronic chest infection.

Life expectancy

Lung cancer survival rates are higher the earlier the cancer is diagnosed. More than two-thirds of lung cancers are diagnosed at a late stage and so survival rates for these patients are lower. Overall, less than 10% of lung cancer patients survive the disease for over five years after diagnosis.

Chronic obstructive pulmonary disease

This is a collective term for a group of conditions that usually occur together, and affect a person’s breathing. Chronic obstructive pulmonary disease (COPD) narrows the airways and makes flow of air to and from the lungs harder, and breathing more difficult. The diagnosis of COPD requires lung function tests, but it is not reversible, and gets worse over time. Two main conditions that indicate COPD are:


Breathlessness caused by damage to the air sacs (alveoli). Chronic bronchitis Coughing with a lot of mucus, wheezing and shortness of breath which lasts for at least three months.


● An infrequent cough producing phlegm is the first symptom. This ‘smoker’s cough’ will gradually become more persistent (chronic)
● Breathlessness and wheezing during exertion, that will worsen as the smoking continues
● An excess of phlegm (sputum)
● An increase in chest infections, as well as a sudden worsening of symptoms (known as exacerbation). Wheezing, coughing and feelings of breathlessness aggravate a sufferer more than usual, while sputum normally turns yellow or green.

Life expectancy

At least 25,000 people die each year in the UK from the end stages of COPD. Many of these people have several years of ill health and poor quality of life before they die. About eight in 10 men with mild COPD will survive for five years or more after diagnosis, compared with seven in 10 women. The survival rate is lower in severe COPD. It is projected to be the fourth leading cause of death globally by 2030 due to increased smoking rates.

Heart disease

Cardiovascular disease is the main cause of death due to smoking. Cigarettes accelerate the hardening and narrowing process of the arteries. When the blood vessels become blocked or rigid (atherosclerosis), blood clots are likely to form. This blockage (thrombosis) stops the heart muscle from getting enough oxygen, and thus working properly.

Heart disease can take many forms depending on which blood vessels are involved and all of them are more common in people who smoke. Thirty per cent of coronary thrombosis cases (a blood clot in the arteries supplying the heart, which can lead to a heart attack) are caused by smoking. Smokers typically develop coronary thrombosis 10 years earlier than non-smokers, and make up nine out of 10 heart bypass patients. 


● Angina – a discomfort, heaviness, pressure, aching, burning or fullness in the chest, often mistaken as indigestion or heartburn. The same pain may also be felt in the shoulders, arms, neck, throat, jaw, or back
● Shortness of breath
● Palpitations or irregular heart beats
● Weakness or dizziness
● Nausea
● Sweating.

Life expectancy

Coronary artery disease is a chronic disease with no cure. It’s crucial to take good care of your heart for the rest of your life to prevent severe blood clotting and heart attacks. This is especially true if you have had an interventional procedure or surgery to improve blood flow to the heart.

The rest

Other cancers Of the mouth, nose, throat, larynx, gullet (oesophagus), pancreas, bladder, cervix, blood (leukaemia), and kidney are all more common in smokers.

Macular degeneration

Heavy smokers are twice as likely to contract the condition, resulting in the gradual loss of eyesight. Smokers also run an increased risk of cataracts.

Rheumatoid arthritis (RA)

Individuals who had smoked 20 cigarettes a day for between 40 and 50 years were over 13 times as likely to have RA, reported a Liverpool study.


The chemicals in tobacco can damage the lining of the blood vessels and affect the level of lipids (fats) in the bloodstream. This hardening of the arteries (atheroma), increases the chance of heart disease, strokes, peripheral vascular disease (poor circulation of the legs), and aneurysms (swollen arteries which can burst causing internal bleeding). Ageing Smokers have paler skin and develop wrinkles at an earlier age than non-smokers, due to a lesser supply of blood and vitamin A to the skin.


This is reduced in smokers (male and female). Sexual health issues are also common, with the risk of erectile dysfunction almost doubled for male smokers in their 30s and 40s.


Women who smoke face going through the menopause at least one year earlier than non-smokers.

Quitting timeline

24 hours: Your lungs start to clear
Two days: Your sense of taste and smell start to improve
Three days: You can breathe more easily, and your energy increases
Two to 12 weeks: Your blood circulation improves
Three to nine months: Coughs, wheezing and breathing improves
One year: Your heart attack risk is  half that of a smoker’s
Ten years: Your lung cancer risk is 50% that of a smoker’s.

‘I want to get on with my life’

Emyl Lewicki, 31, a district operations manager from Glasgow, trialed Liberro electronic cigarettes to help him to quit ‘I’ve been smoking for 16 years and failed miserably every time I’ve tried to quit. Associating cigarettes and alcohol together is bad and I always slip back into the social habit. I’m at an age now where my health can recover. Liberro e-cigarettes have helped me cut down from 10 smokes a day to just two. Even if they just provide the placebo of smoking, they have certainly helped my productivity. Minimising 10-minute fag breaks has limited the distraction of smoking, a valuable tool for anyone looking to quit.’

‘I decided to quit for my daughter’

Andrea Mitchell, 36, a designer from London, gave up smoking with the help of Liberty Flights e-cigarettes ‘As soon as my four-year-old daughter tried to mimic the action of smoking, attempting to take cigarettes out of my hand, I knew it was time to quit. My previous attempts to quit using other inhalators failed because I wasn’t inhaling smoke. As it’s the action of smoking which I like, Liberty Flights e-cigarettes were perfect as a device for me to keep the habit and motion. With many flavours to try, the cigarettes are a little like smoking a sheesha pipe. After two weeks, my morning cravings had gone. They really are great.’

Photograph: Shutterstock

This article was first published in at home’s ’Ask the Doctor’ with Dr Christian Jessen in March 2012. [Read the digital edition here]


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