The devastating impact of cigarettes on life expectancy| Tabaccologia

Article

Tobacco smoke is one of the leading preventable causes of illness, disability and premature death worldwide [1].

Although tobacco epidemiology tells us that, of the 1.3 billion smokers globally, more than half will die from a smoking-related disease, and despite most smokers being aware that smoking harms their health to the point of shortening their life expectancy, they often fail to consider the impact of each individual cigarette they smoke.

A study published in Addiction by University College London (UCL) estimates that each cigarette, on average, takes about 20 minutes off a smoker’s life: 17 minutes for men and 22 minutes for women [2].

An interesting side note is that The Times [3] incorrectly identifies the journal as The Journal of Addiction Medicine (JAM), while The Guardian [4] also errs, referencing the JAM. However, the editorial actually appears in Addiction [2].

The 20 minutes cited is a higher figure than previously thought, as earlier research suggested that each cigarette reduced a smoker’s life by 11 minutes, with a life expectancy reduced by 6.5 years for someone smoking 20 cigarettes per day for one year [5, 6].

Thus, a person who smokes 10 cigarettes per day and quits smoking on January 1, could avoid losing one full day of life by January 8, one week by February 20, and one month by August 5. By the end of the year, they could have avoided losing 50 days of life.

“People generally know that smoking is harmful, but they tend to underestimate the extent of the harm”, said Dr. Sarah Jackson, a lead researcher with the UCL Alcohol and Tobacco Research Group. “On average, smokers who don’t quit lose about a decade of life. That’s 10 years of precious time, moments, and milestones with their loved ones” [4].

Although some smokers live long lives, others develop smoking-related diseases and die as early as in their 40s. The variation depends on differences in smoking habits, such as the type of cigarette used, the number of puffs and how deeply smokers inhale. People also differ in how susceptible they are to the toxic substances in cigarette smoke [4].

Studies suggest that smokers generally lose roughly the same number of healthy life years as total life years [7]. Therefore, smoking primarily erodes the relatively healthy middle years rather than just shortening the period at the end of life, which is often marked by chronic illness or disability. Thus, a 60-year-old smoker typically has the same health profile as a 70-year-old nonsmoker.

Quitting smoking at any age certainly brings benefits, but the sooner smokers get off this death escalator, the longer and healthier they can enjoy their lives.

Communicating this harm in a clear and accessible way to smokers can be challenging. One potentially effective way to convey the damage caused by smoking is to estimate the average loss of life expectancy per cigarette smoked [2].

Although the effectiveness in terms of smoking cessation remains unclear, one possible strategy to increase quit rates could be providing smokers with feedback on the current or potential future biomedical effects of smoking. This could include measurements of exhaled carbon monoxide (CO), lung function, arterial vessel patency, genetic susceptibility to lung cancer or other diseases or the reduced life expectancy per cigarette smoked, undoubtedly increasing motivation to quit [8].

On the other hand, the World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC) [9] recommends informing the general population and, especially, smokers about the risks associated with smoking. It advocates for public awareness campaigns as a key measure to reduce tobacco demand.

References

1. Jha P. The hazards of smoking and the benefits of cessation: a critical summation of the epidemiological evidence in high-income countries. Elife. 2020; 9:e49979. DOI
2. Jackson SE, Jarvis MJ, West R. The price of a cigarette: 20 minutes of life?. Addiction. 2024. DOI
3. Koronka P. Quitting smoking for a week ‘could add a day to your life. The Times. 2024. Publisher Full Text
4. Sample I. Single cigarette takes 20 minutes off life expectancy, study finds. The Guardian. 2024. Publisher Full Text
5. Shaw M, Mitchell R, Dorling D. Time for a smoke? One cigarette reduces your life by 11 minutes. BMJ. 2000; 320:53. DOI
6. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ. 2004; 328:1519. DOI
7. Dieteren CM, Faber T, van Exel J, Brouwer WBF, Mackenbach JP, Nusselder WJ. Mixed evidence for the compression of morbidity hypothesis for smoking elimination – a systematic literature review. Eur J Public Health. 2021; 31:409-17. DOI
8. Clair C, Mueller Y, Livingstone-Banks J, Burnand B, Camain JY, Cornuz J. Biomedical risk assessment as an aid for smoking cessation. Cochrane Database Syst Rev. 2019; 3:4705. DOI
9. World Health Organization. WHO Framework Convention on Tobacco Control. World Health Organization: Geneva; 2003.