A major study published in the BMJ has found that smoking even one cigarette a day carries a substantially increased risk of heart disease and stroke, challenging the notion that cutting down is a safe alternative to quitting.
Researchers analysed 141 studies and concluded that people who smoked a single cigarette daily were about 50% more likely to develop heart disease and 30% more likely to have a stroke compared to non-smokers. For women, the risks were even higher: 57% for heart disease and 31% for stroke.
Lead author Professor Allan Hackshaw of University College London said the findings show there is no safe level of smoking for cardiovascular disease, which causes about 48% of smoking-related premature deaths. He urged smokers to quit completely rather than cut back.
The study indicated that while a 20-a-day habit would cause seven heart attacks or strokes in a group of 100 middle-aged people, reducing to one cigarette a day would still cause three such events. Men smoking one cigarette per day retained 46% of the excess heart disease risk and 41% of the stroke risk of heavy smokers.
However, some experts noted that cutting down with nicotine replacement or e-cigarettes can be a step towards quitting. Professor Paul Aveyard of Oxford University said such approaches often lead to eventual cessation. Public Health England and ASH echoed the call for complete quitting, with ASH emphasising that vaping is less harmful only if smoking stops entirely.
