Occasional smokers still face serious health risks

A recent position statement released by the Royal College of Physicians of Ireland (RCPI) says that even occasional smokers are at a significantly higher risk of lung cancer, cardiovascular disease, fertility problems, and a slew of other health problems compared with non-smokers.

Although the dangers of smoking cigarettes have long been known, there persists a perception that occasional smoking—defined in the report as any smoking that occurs on a less than daily basis—is somehow less dangerous than smoking every day.

In the United States, it is estimated that ~15% of the adult population smokes, and about 25% of those smokers do so occasionally. In prior studies, experts have shown that this population is heterogeneous, with varying smoking patterns. Such smokers are difficult to reach via current educational materials, and smoking cessation techniques typically are focused on daily smokers.

In a recent survey, investigators found that only about 65% and 33% of US adolescents believe that light and intermittent smoking, respectively, are very harmful. Nearly 25% believed intermittent smoking leads to no or little harm.

In the RCPI study, researchers found that occasional smokers were more likely to be young adults with a higher level of income and education compared with daily smokers. They were also more likely to start later, more likely to be from an ethnic minority, and more likely to be female.

Many occasional smokers do not see themselves as smokers, and as such they are often left out of demographic surveys and clinical trials aimed at a smoking population.

“Those who smoke occasionally have almost a 40% greater risk of dying from smoking-related disease compared with non-smokers,” according to Dr. Desmond Cox, Chair of the Policy Group on Tobacco at RCPI, Dublin, Ireland. “They carry almost the same risk of cardiovascular disease as daily smokers. In regard to lung cancers in women ages 35-49, those who smoke between one and four cigarettes a day are five times more likely to develop lung cancer when compared to non-smokers. In men, the risk is three-fold.”

As part of the study, the RCPI released the following recommendations:

• Better awareness about the dangers of occasional smoking is needed among the general public and health-care professionals.
• Health promotion campaigns on the dangers of any pattern of smoking and stricter smoking bans need to be implemented to assist in decreasing the number of people who occasionally smoke.
• Other lifestyle risk factors, including occasional smoking and its associations with alcohol, need to be addressed.
• Improved understanding on why occasional smokers initiate and continue to smoke in this pattern is required.
• The role of different smoking cessation techniques to address the behavioral patterns of occasional smokers need to be examined.
• More research is needed on the long-term smoking patterns and health effects of occasional smoking.

“Other lifestyle choices also need to be addressed,” Dr. Cox said. “It is vital that there is increased awareness of the health implications of occasional smoking. This pattern of smoking is often perceived to have lesser risk and people continue this pattern of smoking over longer periods, increasing their long-term exposure to tobacco smoke. Those in this category often feel no great need to give up for health reasons and do not perceive themselves as smokers.”