Friday, January 4, 2013

Even Intermittent Smoking Is Risky

Do you occasionally have a cigarette, maybe not even every day? Although people resolve to quit smoking in the new year, you might think only heavy smokers need to quit. But that isn't the case.

Light or intermittent smoking has become a very common pattern for people of any age.  Many of these people do not feel addicted to tobacco and do not even call themselves "smokers." There are, however, some real risks associated with any level of smoking. Non-daily smoking, or smoking 1-5 cigarettes a day, was first noticed as far back as 1989 because it was a stark contrast to the more common pattern at that time -- 20 to 30 cigarettes a day. At that time, very light smokers were labeled "chippers" (a term that also referred to occasional users of opiates who appeared to not be addicted). Chippers didn't appear to smoke to relieve withdrawal, and sometimes didn't smoke for a day or more.

Number of 'chippers' growing

Since that time, occasional smoking has become a lot more common. The number of U.S. smokers who claim to not smoke every day increased 40% between 1996 and 2001. In fact, half of U.S. smokers claim to be light or intermittent smokers. Some of this is likely due to the increasing restrictions on smoking in public places and workplaces, and the stigma of being thought of as a smoker. Having less disposable income might also be a factor that accounts for lighter smoking in some racial/ethnic groups, (and why this pattern of smoking is very common in developing countries).

Young adults and college students in particular engage in light or intermittent smoking. Many of them reject the idea that they could be called a "smoker" because they report smoking only in social settings such as at parties, or only when then experience stressful events or are angry. Some of these smokers may feel a need to smoke when drinking alcohol.

Some light or intermittent smokers, particularly young adults, believe that their lighter smoking does not present health risks. And because they don't see themselves as smokers, they don't intend to "quit."

Even light smoking poses risks

No cigarette is without risk, however. Smoking even as little as 5 days out of the month can lead to more shortness of breath and coughing. What's more, smoking just 1 to 4 cigarettes a day can increase the risk of dying from heart disease and all causes, like cancer. For women, the news is even worse:  women's risk of lung cancer from light smoking is greater than men's when compared to never- smokers of both genders.

Other light or intermittent smokers were once heavier daily smokers who have begun to cut down on their smoking on their way to quitting. Cutting down on smoking may make it easier for some smokers to finally kick the habit, and this is probably a worthwhile strategy as long as the smoker can keep the end goal in mind, which is not using tobacco products at all. But smoking 4-5 cigarettes daily can also lead to withdrawal symptoms after 24 hours of abstinence, so some light smokers probably are addicted.

Although we need more research to understand the causes and consequences of light and intermittent smoking, one danger is that this pattern may lead to people gradually smoking more and more,  which increases the difficulty of quitting.  Given the dangers of any level of smoking, research is also needed to help us understand how best to persuade chippers about the risks of light and intermittent smoking.

Fortunately, there are many resources available to help smokers quit that are based on scientific evidence, whatever the level of smoking. These include calling a telephone quitline for support, medications such as Chantix or Zyban, and even online chats and text messages that can give advice and support to smokers when they experience cravings during a quit attempt.

If you smoke - even if it's only a few cigarettes a week - take advantage of these resources and get the help you need to quit.