Is Cutting Down as Good as Quitting Smoking?

For many smokers, the short-lived willpower of a New Year’s resolution to go "cold turkey" often falls short. As a result, resorting to just one or two cigarettes a day is considered a reasonable compromise. However, new research published in the British Medical Journal suggests otherwise. According to researchers just one cigarette a day is just as bad as smoking a whole pack.

Six decades of research suggests "cold turkey" is a must

Supported by Cancer Research UK, the study concluded that smoking one cigarette a day can go hand in hand with the same risks of smoking 20 in the space of 15 hours. This includes developing coronary heart disease or suffering from a stroke. The study draws on almost 60 years of medical studies, with the authors asserting that "We have shown that a large proportion of the risk of coronary heart disease and stroke comes from smoking only a couple of cigarettes each day."

A generation of "light smokers"

The study was sparked by new findings suggesting that while a growing number of smokers actively try to cut down on cigarettes, they aren't aiming to quit altogether. This is largely fuelled by a common belief that "light smokers" aren't exposing themselves to the same risks as their "heavy smoker" counterparts. The team set out to prove this theory wrong and verify that the risk of developing lung cancer isn't linked to the number of cigarettes consumed. Instead, they maintain that the same damage can be done simply by smoking one or two a day.

To validate the findings the team analysed results from over 140 studies that explored the health outcomes of both light, moderate and heavy smokers. They were especially concerned with the “excess relative risk” of smoking one cigarette a day for multiple years, as opposed to a standard pack. Basically, if smoking 20 cigarettes a day correlate with a 127% increased likelihood of heart disease, what percentage of that risk is maintained by only having one or two?

The results were alarming, with the team concluding that when smoking just one a day the risk of developing coronary heart disease decreases by just 53% in men and 38% in women. The results were similar for stroke, with the change in excess risk calculated at 64% and 36%.

“No safe level of smoking exists for cardiovascular disease,” stress the authors. “Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.”

Like all controversial studies, this one has garnered its fair share of criticism. It brings to mind articles like 'Different Measuring Techniques Provide Different Results – But What is the Truth?', which explore how variables can influence outcomes.