Surgeon General: No Amount of Smoking Is Safe
Report Details Biology of Smoking’s Dangers
By Todd Zwillich
WebMD Health News
Reviewed by Laura J. Martin, MD
hand holding cigarette with smoke

Dec. 9, 2010 -- Even a single cigarette poses health risks.

That’s the latest conclusion from the U.S. surgeon general in a new report on the health effects of smoking.

The report, released Thursday, suggests for the first time that even small amounts of smoking or exposure to secondhand smoke can have health consequences, particularly in people with pre-existing disease.

“This report concludes that damage from tobacco smoke is immediate,” said U.S. Surgeon General Regina Benjamin, MD.

Smoking’s deadly effects are well-known. It’s the leading cause of preventable death in the U.S., contributing to an estimated 440,000 premature deaths per year. It’s also the leading cause of lung cancer, emphysema, cardiovascular disease, and a host of other illnesses.

Obama administration officials said their report lays out for the first time the damage smoking can do at the cellular and organ level. For example, the report finds inhaling cigarette smoke causes immediate changes in the lining of blood vessels that can make blood clots more likely.

That can mean an increased risk of a heart attack, even from secondhand smoke, particularly in people who already have cardiovascular disease.

“We didn’t know the fact that when you inhale one cigarette it affects the lining of the blood vessels,” Benjamin told reporters in Washington Thursday.

That effect on blood vessels can also damage a diabetic person's ability to control their blood sugar and can make the consequences of poor control more pronounced, Benjamin said. Vascular damage in diabetic people often leads to kidney problems, nerve damage, and blindness.

The root of the problem is that even small amounts of the chemicals in cigarette smoke cause rapid inflammation in the endothelium, or lining, of blood vessels and in the lungs. Inflammation is increasingly blamed by researchers as a key promoter of blood vessel plaques and clots and in obstructive lung diseases like emphysema.

“The evidence on the mechanisms by which smoking causes disease indicates that there is no risk-free level of exposure to tobacco smoke,” the report concludes.

One-fifth of U.S. adults and adolescents smoke, according to federal data. The White House has announced a goal of reducing that rate to 12% by 2020.

One smoker who’s trying to quit is Benjamin’s boss, President Obama. Benjamin was asked by a reporter what advice she would give to the president.

“I’d give him the same advice I give to any patient, to try their best to quit smoking.”