The Bottom Line

1. If I start smoking occasionally, what is the risk that I will become a daily (addicted) smoker?

Answer: About 50%. If you are already smoking 10 cigarettes a day you are probably already addicted. If you are already smoking 20 cigarettes (1 pack) a day you are almost certainly addicted.

2. If I am a regular smoker, what are my chances of successfully quitting long term on any given quit attempt?

Answer: If you try quitting on your own, your chance of long term success (e.g., greater than 1 year) on any given quit attempt is less than 5%. With brief smoking cessation advice by a physician plus a brief leaflet on how to stop smoking, your chances of quitting long term are more than doubled to just over 5%. If pharmacotherapy (i.e., nicotine replacement and/or bupropionSR therapy) are added to this, your chances of quitting long term are again doubled to more than 10%. If you have the best comprehensive help (i.e., a formal quit smoking behavioral change program, physician counseling with follow-up, pharmacotherapy and social support from friends and family), your chance of long term success in quitting is perhaps 25%. Your chances of successfully quitting for good increase with each quit attempt. So if you are unsuccessful on any given try, keep trying and apply what you've learned from previous failed attempts.

3. What is my risk of dying early from smoking, how early and from what?

Answer: If you are a regular smoker who is under 18 years of age, your risk of dying prematurely from smoking is 1 chance in 3 (33%). If you continue to smoke long term, your risk of dying 15 years (on average) prematurely from smoking is 50%. If you continue to smoke heavily, you can expect a life expectancy at least 25% shorter than a non-smoker. (Source: American Thoracic Society). Your premature death will be caused by cancer, cardiovascular disease and/or lung disease. (i.e., from one or more of the following diseases: cancer of the mouth, throat, lung, esophagus, bladder, kidney, stomach, pancreas and cervix; heart attack, heart failure, stroke, emphysema and chronic bronchitis).

4. When does the damage from smoking start?

Answer: The damage begins almost immediately after you start to smoke and continues to progress with time. There are both early (days, weeks, months) and later (years) health consequences of smoking. (See Table on pg 56). The early consequences of smoking include: retardation of the growth and development of the lung (in youths), increased occurrence of cough and phlegm production, asthma, bronchitis and respiratory infections, increased blood levels of carbon monoxide which robs the blood of oxygen, decreased energy, endurance, breathing capacity and athletic ability, altered fat content in blood which favors early coronary heart disease, black lung, a proclivity for pre-cancerous mutations in lung cells, poor hygiene (bad smelling breath, hair, hands and clothes), infertility, complications of pregnancy, impotence and nicotine addiction. The severity and tenacity of nicotine