Only smoke at parties? Don’t kid yourself that it’s doing no harm

Smoking ANY cigarettes doubles your risk of early death

Consider yourself a social or occasional smoker? do you only smoke at parties and not think of yourself as being a ‘real’ smoker? it’s estimated that 2per cent of adults fall into this category and it’s thought they smoke on average less than one cigarette a day.

Common sense says the risks of smoking this amount are smaller than those faced by daily smokers — but they are not as low as you might think.

For some health conditions, such as cancer, the risk largely corresponds to how much you smoke.

But for other problems, including heart attack and stroke, even one cigarette can make a big difference.

Last month, a study of more than 65,000 people found that those who puffed 20 cigarettes a day had a high risk of developing a common and deadly type of stroke caused by a brain bleed.

But so, too, did those who smoked between one and ten cigarettes a day.

The results, published in the journal stroke, found that these lower-level smokers had around a three times greater risk than people who didn’t smoke at all.

Women had a higher risk than men — the researchers suggested smoking even one cigarette a day regularly reduces oestrogen levels, which disrupts collagen (a protein that helps maintain the structure of blood vessels and skin) making the blood vessels weaker and increasing inflammation in vessel walls.

‘This is a very large study, so we can be confident in the results,’ says dr Martin James, a consultant stroke physician at royal devon & exeter Hospital.

Problems can arise when people don’t understand the risks that even occasional cigarettes can pose to their health.

A 2014 survey showed that of Britain’s 1.1 million ‘part-time’ smokers, only one in four was concerned about harm.

They consistently described their habit as social — despite the fact that some smoked up to 37 cigarettes a week.

One cigarette cuts your life by 11 minutes, according to a study published in the BMJ in 2000.

Lifelong smokers — such as those who smoke 20 a day or more — lose at least ten years of their life, while light smokers, smoking fewer than five a day, lose four to six years, says Lion shahab, a senior lecturer in health psychology at University College London. ‘Any smoking at all doubles the risk of dying prematurely.’

And evidence suggests that those who consider themselves ‘casual’ smokers are anything but. A 2014 study by University College London (UCL) researchers found that around 80per cent of occasional smokers weren’t able to quit. The difference is that rather than people needing a constant ‘fag fix’, occasional smokers’ brains have developed an association between the situation they smoke in and the need to smoke — creating an impulsive craving for nicotine when they are there — which is known as an occasional addiction. Whether you smoke one cigarette a week, one a day or 20 a day, a smoker is a smoker, and ‘regardless of the number, they are an addict to some degree and this has implications for their health,’ says Melody Holt, of the roy Castle Lung Cancer Foundation.

robert West, a professor of health psychology at UCL, says that the term ‘social smoking’ is a misnomer: ‘Whether you smoke socially or not is not the issue, it’s the amount of toxic chemicals you are inhaling.’

nicotine poses few health risks, but it’s the chemical that causes addiction, while the other 600odd ingredients in a cigarette are what can be harmful.

‘Many occasional and social smokers puff an awful lot and in some cases more than daily smokers,’ says Professor West.

‘Averaging five cigarettes a day — over a week or in one go — has the same effect on health. it comes down to the amount of toxins your body is exposed to.’

Labels such as social smoker change how people perceive the risks of their habit, says dr James. He sees many patients who say they are not smokers, but ‘may have a few at the weekend’.

‘But even occasional cigarettes can put your health at risk — the only safe level of smoking is nothing at all.’

As with regular smoking, one of the major risks of intermittent smoking is heart disease.

And one study found smoking even one to four cigarettes a day can triple the risk of dying from heart disease.

This is down to the fact smoking increases furring up of arteries, raising the risk of a heart attack due to clots and reduced blood flow. Here, being a social smoker is particularly dangerous — going from no cigarettes to one cigarette is the most critical and riskiest change, says Professor West.

This is because when inhaling the cigarette, the body produce cells called macrophages to clear gunk from lungs. But breaking down this gunk also releases a protein known as prothrombin, which immediately makes blood stickier and more likely to clot.

Any level of smoking can also affect men and women’s fertility, says Lion shahab. A study this year found smoking just one cigarette may promote an inflammation in men that can lead to damage of dnA in their sperm and lowers the chances of fertilising an egg successfully.

Light smoking can also raise the risk of ectopic pregnancies (where the embryo implants outside the womb), says Lion shahab.

A 2010 edinburgh University study showed inhaling any amount of cigarette smoke triggers a reaction that increases levels of a protein in the Fallopian tubes that raises the risk of the egg implanting elsewhere.

For cancer risks, the effect of smoking is cumulative. How many cigarettes you smoke on average and the length of time for which you smoke affects the chance.

even light smokers’ risk of lung cancer is five times higher than for non-smokers. Part of the problem is the way light smokers actually smoke. someone may say they are non-daily, occasional smokers, but research looking at these people’s nicotine intake suggests it is not that different from daily smokers, says Professor West.

This suggests a difference in the smoking technique.

Light smokers are thought to burn their cigarettes right down to the end and tend to inhale each puff as hard as they can, more so than regular smokers.

‘Light smokers tend to take in more nicotine from each cigarette than heavy smokers,’ says Professor West.

‘They drag more deeply on their cigarettes and often hold the smoke down for longer.’

THe theory is that above a certain concentration in the brain, nicotine starts to cause a reaction so that people start to feel sick and edgy. Those lighting up regularly would be familiar with this reaction, so learn not to inhale the entire cigarette.

‘But light smokers can afford to take in more from each cigarette because they smoke fewer and so the nicotine levels in their blood will stay within acceptable limits,’ says Professor West.

‘The average cigarette could provide as much as 6mg of nicotine, though most smokers take in only about 1mg.’

The average smoker takes ten puffs and doesn’t inhale deeply while light smokers are more likely to inhale more per cigarette.

There is some good news from last month’s Finnish study on stroke risk, though: the conventional thinking is it takes months or years for the body to ‘heal’ damage caused by smoking.

However, the researchers found people who quit smoking lowered their risk of brain haemorrhage after just six months of quitting.

it’s an important message for those trying to quit, says dr James: ‘Many who try and fail believe that the damage is already done. But clearly this idea is changing, and it really is never too late to give up.’