Ask the GP: smoking Q&A

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

Want to quit?

Find out about your local NHS stop-smoking services and call the NHS Smoking Helpline on 0800 022 4332 (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.

A study of 43,000 Norwegian smokers published in 2005 suggested that those who smoked up to five cigarettes a day were three times more likely to die of 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, bladder, pancreas and many more. Smoking also makes it more difficult to conceive; it lowers sperm count and causes more complications in pregnancy. 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 cardiovascular causes compared with non-smoking diabetics. People smoking up to 15 cigarettes a day have a 50% higher chance, while ex-smokers have a 10-30% increased chance, even 10 years after quitting.

I find it so hard to stop smoking. Am I weak?
No. Having trouble stopping 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 blood stream within a few drags, and alters various brain chemicals that change mood and concentration, which smokers find enjoyable. Stopping smoking can lead to intense feelings of anxiety, irritability and depression, which smokers crave cigarettes to get rid of. Using nicotine replacement therapy (NRT) can help people break this physically addictive cycle.

While many people conquer their physical addiction for a few weeks or months, cigarettes are also psychologically and socially addictive. Being in a certain mood or place, or with certain people, can make ex-smokers light up again months or years later. Increasing social support while you quit by stopping with a partner or friend can help, as can joining an NHS stop-smoking group. Keeping in your purse or wallet a list of why you stopped, or a picture of your child or partner, or maybe a friend who died from smoking, can help you to avoid lighting up in years to come.

Last reviewed: 23/07/2010

Next review due: 23/07/2012

Comments are personal views. Any information they give has not been checked and may not be accurate.

Jane said on 26 August 2008

Try contacting your local NHS stop smoking service who should be able to help you. You can find their details from 0800 169 0 169 or www.nhs.uk/gosmokefree. They will have a range of services which should meed your needs.

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trish501 said on 19 May 2008

I have to agree with the above comment! I recently found out I had engina, at 48, female, fit and slim I thought it wasn't possible, I asked my doctor for help to stop smoking and he gave me a leaflet to phone a club, this is all very well , however, it took me 3 weeks to find out about my engina because of work commitments making it hard to make time for an appointment,, what chance have I of attending a clinic!

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Anonymous said on 18 April 2008

I want to give up smoking and went to see my gp, only to be told she could not help me. What is the point of asking for help when you get turned away. I dont know who else to try, i have tried patches etc with no luck. How can i give up smoking when i cant seem to get any help or support?

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