smoking
Smoking = Bad for you = Duh
, , Filed in: Smoking | Preventive Health
Unless you’ve been on Mars you’ve heard that smoking is bad for you. Smoking is generally accepted to be the leading cause of preventable death and disease. These are the main reasons you should consider stopping if you are still smoking.
1 - Cancer - Lung Cancer kills more people than the next 4 cancers combined. You hear a lot about colon cancer, breast cancer, breast cancer, melanoma but compared to lung cancer these are insignificant in terms of mortality. Maybe they have better press agents but those other cancers don’t kill near as many people as lung cancer does. Part of the problem is that the cure rate for lung cancer has hovered around 11% for years. 75% of patients diagnosed with lung cancer already have metastatic disease and are thus not curable with surgery - still the only cure. This happens because the lungs are big and a cancer can grow for months if not years without causing any symptoms at all. There won’t be symptoms until the tumor either blocks an airway or interferes with a nerve or vascular structure or until the patient coughs up blood. Other than cutting down on smoking, the only way to have a meaningful improvement in the cure rate for lung cancer is to increase early detection. Various studies are being done to determine if there is a cost effective way to screen for lung cancer. In my practice, I recommend an annual chest x-ray for anyone who has ever smoked. This may not be cost effective but it saves lives in my experience as many lung cancers cured by surgery were actually discovered on randomly obtained chest x-rays in many cases done for other reasons like after a car accident.
How big a deal is smoking in causing lung cancer? As of 2008 I’ve been in this practice 11 years. During that time we have steadily discovered 1 or 2 new lung cancers per week or have found about 75-100 cancers per year. Multiply that times 11 years and it’s close to 1000 lung cancers we’ve diagnosed. Of those, only 4 had never been smokers. Some had quit 20 years before the diagnosis (unfortunately the risk never totally goes away even though it gets smaller with each year away from smoking). Lung cancer in non-smokers is so rare that in many cases the cancer isn’t lung cancer at all but is a cancer of some other organ that just happened to spread to the lungs.
Finally, other cancers such as bladder cancer also occur more frequently in smokers.
Bottom line - not all smokers get lung cancer but almost all lung cancer occurs in smokers or former smokers.
2- Lung disease - it’s widely known that in many (though not all) patients, smoking leads to chronic bronchitis, emphysema, and chronic obstructive pulmonary disease. So far as second hand smoke the only proven bad effect other than the fact that you smell bad is that children who grow up in the house of a smoker are more likely to develop asthma and are more likely to miss time from school due to various illnesses.
3- Vascular disease - This includes coronary artery disease (leading to heart attacks), cerebrovascular disease (leading to strokes), and peripheral vascular disease (leading to amputations). In fact, with severe peripheral vascular disease it’s rare to see the disease in a patient who has never smoked.
Don Elton, MD
1 - Cancer - Lung Cancer kills more people than the next 4 cancers combined. You hear a lot about colon cancer, breast cancer, breast cancer, melanoma but compared to lung cancer these are insignificant in terms of mortality. Maybe they have better press agents but those other cancers don’t kill near as many people as lung cancer does. Part of the problem is that the cure rate for lung cancer has hovered around 11% for years. 75% of patients diagnosed with lung cancer already have metastatic disease and are thus not curable with surgery - still the only cure. This happens because the lungs are big and a cancer can grow for months if not years without causing any symptoms at all. There won’t be symptoms until the tumor either blocks an airway or interferes with a nerve or vascular structure or until the patient coughs up blood. Other than cutting down on smoking, the only way to have a meaningful improvement in the cure rate for lung cancer is to increase early detection. Various studies are being done to determine if there is a cost effective way to screen for lung cancer. In my practice, I recommend an annual chest x-ray for anyone who has ever smoked. This may not be cost effective but it saves lives in my experience as many lung cancers cured by surgery were actually discovered on randomly obtained chest x-rays in many cases done for other reasons like after a car accident.
How big a deal is smoking in causing lung cancer? As of 2008 I’ve been in this practice 11 years. During that time we have steadily discovered 1 or 2 new lung cancers per week or have found about 75-100 cancers per year. Multiply that times 11 years and it’s close to 1000 lung cancers we’ve diagnosed. Of those, only 4 had never been smokers. Some had quit 20 years before the diagnosis (unfortunately the risk never totally goes away even though it gets smaller with each year away from smoking). Lung cancer in non-smokers is so rare that in many cases the cancer isn’t lung cancer at all but is a cancer of some other organ that just happened to spread to the lungs.
Finally, other cancers such as bladder cancer also occur more frequently in smokers.
Bottom line - not all smokers get lung cancer but almost all lung cancer occurs in smokers or former smokers.
2- Lung disease - it’s widely known that in many (though not all) patients, smoking leads to chronic bronchitis, emphysema, and chronic obstructive pulmonary disease. So far as second hand smoke the only proven bad effect other than the fact that you smell bad is that children who grow up in the house of a smoker are more likely to develop asthma and are more likely to miss time from school due to various illnesses.
3- Vascular disease - This includes coronary artery disease (leading to heart attacks), cerebrovascular disease (leading to strokes), and peripheral vascular disease (leading to amputations). In fact, with severe peripheral vascular disease it’s rare to see the disease in a patient who has never smoked.
Don Elton, MD