Consider yourself a ‘social’ or ‘occasional’ smoker? Do you only ‘smoke at parties’ and don’t consider yourself as a ‘real smoker’.
It’s estimated that 2 per cent of Britain’s adult population fall into this category and it’s thought they smoke on average less than one cigarette a day.
Common sense says the risks of smoking this amount are smaller than those faced by daily smokers – but they are not as low as you might think.
For some health conditions, such as cancer, the risk largely corresponds to how much you smoke. But for other problems, including heart attack and stroke, even one cigarette can make a big difference.
Last month a study of more than 65,000 people found those who puffed on 20 cigarettes a day had a high risk of developing a common and deadly type of stroke caused by a brain bleed.
But so, too, did those who smoked between one and ten.
The results, published in the journal Stroke found that these lower-level smokers had around a three-times greater risk than people who didn’t smoke at all.
Women had a higher risk than men – the researchers suggested smoking even one cigarette a day regularly reduces oestrogen levels, which disrupts collagen making the blood vessels weaker, and increasing inflammation in vessel walls.
“This is a very large study, so we can be confident in the results,” says Dr Martin James, a consultant stroke physician at Royal Devon & Exeter Hospital.
Problems can arise when people don’t understand the risks that even occasional cigarettes can pose to their health.
A 2014 survey showed that of Britain’s 1.1 million ‘part-time’ smokers, only one in four was concerned about harm. They consistently described their habit as ‘social’ despite the fact that some smoked up to 37 a week.
One cigarette cuts your life by 11 minutes, according to a study published in the BMJ in 2000. Lifelong smokers – such as those who smoke 20 a day or more – lose at least ten years of their life. However light smokers who light fewer than five cigarettes a day, lose four to six years, says doctor Lion Shahab, a senior lecturer in health psychology at University College London.
And evidence suggests casual smokers are anything but. A 2014 study by University College London researchers found that around 80 per cent of occasional smokers weren’t able to quit.
The difference is that rather than people needing a constant ‘fag fix’, occasional smokers’ brains have developed an association between the situation they smoke in and the need to smoke – creating an impulsive craving for nicotine when they are there – an ‘occasional addiction’.
Whether you smoke one cigarette a week, one a day or 20 a day, a smoker is a smoker, and ‘regardless of the number, they are an addict to some degree and this has implications for their health,’ says Melody Holt, of the Roy Castle Lung Cancer Foundation.
Robert West, a professor of health psychology at University College London says the term ‘social smoking’ is a misnomer. “Whether you smoke socially or not is not the issue, it’s the toxic chemicals you are inhaling.”
Nicotine poses few health risks but it’s the chemical that causes addiction, while the other 600-odd ingredients in a cigarette that are what can be harmful.
“Many occasional and social smokers puff an awful lot and in some cases more than daily smokers,” says Professor West.
“Averaging five cigarettes a day – over a week or in one go has the same effect on health, it comes down to the amount of toxins your body is exposed to.”
Labels such as ‘social smoker’ change how people perceive the risks of their habit, says Dr James. He sees many patients who say they are not smokers but ‘may have a few on a weekend’. “But even occasional cigarettes put health at risk – the only safe level of smoking is nothing at all.” As with regular smoking, one of the major risks of intermittent smoking is heart disease. One study found smoking even one to four cigarettes a day can triple the risk of dying from heart disease.
This is because smoking increases the furring up of arteries, raising the risk of a heart attack due to clots and reduced blood flow. Here, being a social smoker is particularly dangerous – going from no cigarettes to one cigarette is the most critical and riskiest, says Professor West.
This is because when inhaling the cigarette the body produce cells called macrophages to clear gunk from lungs.