Still More Diseases Linked to Smoking

The dangers of smoking cigarettes have been well documented for a long time, but new research shows that inhaling tobacco is even more hazardous than we knew.

Scientists writing earlier this month in the New England Journal of Medicine (NEJM) found that in addition to lung cancer, heart disease and stroke, smoking also raises the risk of dying of several other diseases, including several cancers and infections.

As summarized on, smoking-related deaths increased by 17% from several diseases that, until now, didn’t have established relationships with cigarettes. This was impressive research that included data from five large cohort studies involving 1 million adult subjects, although there were some limitations to the study.

Participants, for example, were mostly white and well educated, and smoking patterns were self-reported. Also, the associations could be complicated by other risk factors such as diet, physical activity and access to medical care.

Still, the risk for smokers versus nonsmokers of dying from these disorders ranged from 30% higher for breast cancer to 500% higher for intestinal ischemia, which is injury to the small intestine resulting from inadequate blood supply.

“Although these associations should be investigated further,” the researchers wrote, “our results suggest that the number of persons in the U.S. who die each year as a result of smoking cigarettes may be substantially greater than currently estimated.”

According to a report last year from the Surgeon General, 480,000 Americans die of 21 smoking-related diseases each year.

Last year we blogged about the latest (bad) news about smoking, and in 2013, we discussed myths about tobacco use. See these blogs if you want to know more about the emerging science on electronic cigarettes.

As MedPageToday noted, health officials have believed for a long time that many of the diseases newly surveyed are associated with smoking, but data to support their suspicions had been lacking. Dr. Norman Edelman, senior consultant for scientific affairs at the American Lung Association, told the reporters, “What’s unique about this study is the data. They have large populations and very large numbers, which provide the statistical power to identify small, but statistically significant effects that couldn’t be seen in smaller studies. Most of these [diseases] have been suspected, and now we know that there are many other things related to smoking other than the dozen or so that have already been proven.”

“When you run the numbers and add up all the deaths attributable to smoking, you come up with an astonishing increase.”

The research included any category that accounted for at least 20 deaths over an 11-year period. Of the 181,377 study participants who died, 16,475 deaths occurred among current smokers. Subjects were all 55 or older. Investigators analyzed data in 52 different cause-of-death categories.

Among gender-specific diseases without previously established associations with smoking, prostate cancer mortality was 40% higher in men who smoked, and breast cancer mortality was 30% higher in women who smoked.

For diseases that affect both genders, researchers found significant mortality associations with current smoking for:

  • infections
  • intestinal ischemia
  • hypertensive heart disease
  • renal (kidney) failure
  • respiratory diseases
  • liver cirrhosis

The risk of dying increased significantly as the number of cigarettes smoked increased, especially deaths from infections, breast cancer and kidney failure. But the good news, if there is any in such a grim report, is that the risk of dying of these diseases among former smokers decreased the longer they went without smoking.

The message is louder and clearer than ever: Stop smoking! You will feel better and save yourself a lot of trouble.

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