Ask the GP: smoking Q&As

GP Dr Michael Apple answers some of your queries about quitting and the health risks of smoking.

Want to quit?

Call the NHS Smoking Helpline on 0300 123 1014 (7am to 11pm)

I smoke fewer than five a day. What's the harm in that?

Almost a third of smokers smoke fewer than 10 a day and often don’t see the point of giving up. But most of the heart disease risk comes within the first few cigarettes of the day.

Next time you light up, feel your pulse. It will start rising within a minute. That’s extra work for your heart, which gets less blood supply because of nicotine. Your blood tends to clot more with each cigarette, and the amount of oxygen it can carry goes down. Instead of oxygen, the blood cells carry carbon monoxide. All of these are risk factors for heart disease.

Smoking just one cigarette a day trebles your risk of lung cancer and raises the risk of chronic lung disease, as well as cancer of the mouth, throat cancer, bladder cancer, pancreatic cancer and many more. 

Many studies have shown that the risks increase the more you smoke, but all risks start with just one cigarette.

I get indigestion. Could it be because I smoke?

Yes. Smoking reduces the ability of the walls of the stomach to repair themselves. Therefore it increases the chances of acid indigestion and duodenal ulcer. If you stop smoking, food may become a lot more enjoyable. You'll taste it better and it’s less likely to give you indigestion. Some people find that their irritable bowel syndrome (IBS) improves when they quit.

What is it about diabetes and heart disease that makes smoking so dangerous?

In these conditions, the blood flow to your heart, legs, kidneys, eyes and brain is already affected, which increases the risk of strokes and heart attacks. Other risks are slow-healing ulcers and diseased legs and toes that might require amputation. When you smoke, you double or treble those risks.

Heavy smokers with diabetes have roughly double the chance of death from heart disease or stroke than they would have if they didn't smoke.

I find it so hard to stop smoking. Am I weak?

No. Finding it hard to stop smoking doesn’t make you weak; it makes you human. Cigarettes are so addictive that 70% of smokers say they would like to quit, yet they still smoke. Most ex-smokers try to stop a few times before they manage to quit for good.

It’s the nicotine in cigarettes that's physically addictive. It reaches the bloodstream within a few seconds and alters various brain chemicals that change mood and concentration.

Stopping smoking can lead to feelings of anxiety, irritability and depression, and these feelings can be increased if you stop without replacing the nicotine from cigarettes with a safe alternative source.

Using nicotine replacement therapy (NRT) can help reduce these negative feelings and increase the likelihood of you staying off cigarettes for good.

Why is passive smoking such a health hazard?

People who breathe in second-hand smoke (smoke from other people’s cigarettes) inhale more than 4,000 chemicals, at least 50 of which are known to cause cancer. For non-smokers, breathing other people’s smoke means an increased risk of lung cancer, heart disease and stroke.

For children, breathing in secondhand smoke means twice the risk of chest illnesses, including pneumonia, croup (swollen airways in the lungs) and bronchitis, plus more ear infections, wheezing and asthma. They also have three times the risk of getting lung cancer in later life compared with children who live with non-smokers.

Can’t I just cut down rather than give up?

The best way to stop smoking is to do so in one step. However, people who cut down the amount they smoke are more likely to stop smoking eventually, particularly if they use licensed nicotine-containing products.

Cutting down, usually by replacing some cigarettes with nicotine-containing products, is known as harm reduction and there are four recommended methods. These are:

  • Stopping smoking, but using one or more licensed nicotine-containing product as long as needed to prevent relapse
  • Cutting down in the lead up to stopping smoking
  •  Smoking reduction
  • Temporary abstinence from smoking

It's important to remember that cutting down is not removing the harm that smoking does, only stopping entirely will do that.

The best advice if you want to reduce your smoking is to use a nicotine containing product to replace cigarettes you don't smoke.

This extra nicotine works in two ways: firstly it can reduce 'compensatory smoking', this is the action of taking more drags and inhaling more deeply on cigarettes to deliver more of a hit.

Secondly, it allows you to gradually replace cigarettes with a safer alternative you're not smoking at all.

Speak to your local stop smoking service for more information about cutting down and the range of products that can help you.

I’m worried I’ll put on weight when I stop.

Cigarettes do affect your appetite and your metabolism, and they dull your taste buds, so people often gain a few pounds when they give up.

You can prevent that by doing more exercise and staying away from high-calorie foods. But if you do gain a little weight, don’t worry: you can lose it again once you’ve quit the cigarettes.

Read more on how to stop smoking without putting on weight.

 

Page last reviewed: 16/01/2016

Next review due: 16/01/2018

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