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The dangers of smoking have been publicized for decades, but people who are "social smokers" — who only smoke at parties, social events, or rare occasions — may believe they aren't subject to the same health dangers as pack-a-day smokers. That couldn't be further from the truth, experts tell Bustle. Social smoking, even if it only occurs on rare occasions, can result in serious health issues, especially for your lungs and heart, and can cause nicotine addiction.
A study of U.S. adults aged 18-24 in 2017 found that 18% identified as social smokers, but doctors say "social smoking" is an imprecise term because it describes a lot of different behaviors, doctors tell Bustle — and that's part of why both modes of smoking are bad for your health.
"'Social smoking' is often used in order to describe an intermittent smoking behavior," Dr. Panagis Galiatsatos, M.D., assistant professor of pulmonary medicine at Johns Hopkins Medicine and spokesperson for the American Lung Association, tells Bustle. "However, this language is usually misleading. For some people, it can be one cigarette, and for others, it can be one to two packs in an outing."
Even for people who smoke very rarely, studies say that incremental lung and heart damage can escalate over time. People who smoke several cigarettes at social occasions might not think of themselves as smokers, but doctors tell Bustle that so-called social smokers aren't immune to the health dangers of smoking, particularly when it comes to lung and cardiovascular health.
Here are five things that social smoking can do to your body.
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It Damages Lung Function
An occasional cigarette at parties can end up being as damaging for your lungs in the long term as a more serious smoking habit, experts tell Bustle. "Researchers have found out that those who smoke less than five cigarettes per day have the same decline in function as those who smoke more than 30 cigarettes per day," Dr. Osita Onugha, M.D., an assistant professor of thoracic surgery at the John Wayne Cancer Institute at Providence Saint John's Health Center, tells Bustle.
A study published in Circulation in 2010 also found that light and intermittent smoking was associated with lower respiratory tract infections and coughs, and the U.S. Surgeon General's office notes that there's no safe level of cigarette smoke exposure, as a single cigarette is enough to begin damaging DNA and inflaming the lungs, resulting in more illnesses like bronchitis. In 2019, a study published in The Lancet showed that low-intensity smokers, who smoked fewer than five cigarettes a day on average, showed nearly the same decline in lung function over time as heavy smokers who smoked over 20 cigarettes daily.
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It Increases Your Risk Of Heart Disease
Social smoking can also create pressure on your heart. "There are several studies that have demonstrated even small, casual cigarette smoking increases the risk of heart disease," Dr. Onugha tells Bustle. According to the Pooling Project on Diet and Coronary Heart disease study, which was published in 2014, people who smoked fewer than 15 cigarettes a day increased their risk of heart disease almost two times compared to non-smokers — and Dr. Onugha says it's riskier for women. "The coronary risk is elevated in women who smoke as little as one to two cigarettes per day," he tells Bustle.
An analysis of 141 cohort studies published in The British Medical Journal in 2018 also found that fewer than one cigarette a day can increase stroke risk and the likelihood of developing coronary heart disease, though it's lower than the risk experienced by heavier smokers.
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You're At Risk Of Second-Hand Smoke Inhalation
People who smoke socially will be exposed not only to their own cigarette smoke, but to that of others, experts tell Bustle, and that creates additional health issues.
"In addition to firsthand smoking, you’re also exposed to a significant amount of secondhand smoke that reaffirms the addiction," Dr. Galiatsatos tells Bustle. Second-hand smoke inhalation may have effects on lung function and health over time. According to the National Cancer Institute, second-hand smoke caused over 7,300 lung cancer deaths among adult nonsmokers annually between 2005 and 2009 in the U.S. A study in 2017 in Chile also found that exposure to second-hand smoke over time damaged the lung health of non-smoking workers.
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It Is Addictive
Social smokers may believe that they're not "really" addicted to nicotine, or that they're able to stop any time they want, but the reality of nicotine dependence is more complicated, according to experts.
"Social smoking poses long-term risks, specifically, forming a nicotine addiction and tobacco dependence," Dr. Galiatsatos tells Bustle. Nicotine and tobacco are highly addictive substances, and the Harvard Medical School notes that nicotine dependence can lie behind intermittent and light smoking, even if it doesn't take the form of a daily need to smoke. Some intermittent smokers may experience a sudden urge for a cigarette after a long period without smoking one, and that's a recognized symptom of nicotine dependence.
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Even Occasional Smoking Increases Lung Cancer Risk
A few cigarettes can still contribute to a higher overall lung cancer risk, experts say. "Most studies indicate that whether someone is a regular or social smoker, they are at higher risk for lung cancer as their years of smoking increase," Dr. Mark Dylweski, chief of general thoracic surgery at Miami Cancer Institute, tells Bustle. "The longer someone smokes, regardless of how much they smoke on a daily basis, the higher the risk of developing lung cancer over a non-smoker."
The Circulation study found that women between the ages of 35 and 49 who smoked an average of one to four cigarettes a day had five times the risk of developing lung cancer as women who didn't smoke at all, and men had three times the risk. Tracking the exact lung cancer risks of social smokers can be difficult because their average cigarette consumption can vary and be spread irregularly over a month, but experts say smoking of any kind increases lung cancer risk. "Even smoking a few cigarettes a day or smoking occasionally increases the risk of lung cancer," the Centers for Disease Control & Prevention wrote in 2019. "The more years a person smokes and the more cigarettes smoked each day, the more risk goes up."
Precise outlines of risk are difficult. "Studies do not differentiate between regular or casual smokers," Dr. Dylweski tells Bustle. "Theoretically, the risk of developing lung cancer is higher among regular smokers, but the science is not specific enough to tell us exactly what that level of risk is."
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Ultimately, there's no safe way to smoke. "The bottom line is that if a person puts known carcinogens and co-carcinogens in their body, even in small doses, these can cause cancer. Any smoking at any level is risky and unhealthy," Dr. Dylweski says.
If you classify yourself as a social or occasional smoker, experts tell Bustle, it's a good idea to look more closely at your smoking behavior. "If you’re using the term 'social smoking,' I would ask that you further explore what that means to you," Dr. Galiatsatos says. "Sometimes, this language is used to convince yourself that you’re not addicted when in fact, you might be.”
Quitting smoking can be tricky, but the American Lung Association and the CDC have programs to help make quitting easier. Even the occasional cigarette at a party can increase pressure on your lungs and heart over time, so it's important to look at your smoking habits clearly to understand how they can affect your health.
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Experts:
Dr. Mark Dylweski, chief of general thoracic surgery at Miami Cancer Institute
Dr. Panagis Galiatsatos, M.D., assistant professor of pulmonary medicine at Johns Hopkins Medicine and spokesperson for the American Lung Association
Dr. Osita Onugha, M.D., assistant professor of thoracic surgery at the John Wayne Cancer Institute at Providence Saint John's Health Center
Studies referenced:
Hackshaw A, Morris JK, Boniface S, Tang JL, Milenković D. (2018) Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 360:j5855. doi: 10.1136/bmj.j5855.
Oelsner, E.C., Balte, P.P., Bhatt, S.P., Cassano, P.A., et al. (2019) Lung function decline in former smokers and low-intensity current smokers: a secondary data analysis of the NHLBI Pooled Cohorts Study. Lancet Respir Med. pii: S2213-2600(19)30276-0. doi: 10.1016/S2213-2600(19)30276-0.
Parro, J., Aceituno, P., Droppelmann, A., Mesías, S., Muñoz, C., Marchetti, N., & Iglesias, V. (2017). Secondhand tobacco smoke exposure and pulmonary function: a cross-sectional study among non-smoking employees of bar and restaurants in Santiago, Chile. BMJ open, 7(10), e017811. doi:10.1136/bmjopen-2017-017811
Schane, R. E., Ling, P. M., & Glantz, S. A. (2010). Health effects of light and intermittent smoking: a review. Circulation, 121(13), 1518–1522. doi:10.1161/CIRCULATIONAHA.109.904235
Tolstrup, J. S., Hvidtfeldt, U. A., Flachs, E. M., Spiegelman, D., Heitmann, B. L., Bälter, K., … Feskanich, D. (2014). Smoking and risk of coronary heart disease in younger, middle-aged, and older adults. American journal of public health, 104(1), 96–102. doi:10.2105/AJPH.2012.301091
Villanti, A. C., Johnson, A. L., Rath, J. M., Williams, V., Vallone, D. M., Abrams, D. B., … Mermelstein, R. J. (2017). Identifying "social smoking" U.S. young adults using an empirically-driven approach. Addictive behaviors, 70, 83–89. doi:10.1016/j.addbeh.2017.02.004
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