You might think having an occasional cigarette at a bar or a party isn’t a big deal.
Or that a once-in-a-while puff won’t harm your health.
If so, then you’d be wrong on both counts.
“Social smokers” — those who smoke in social situations, but not daily — face similar cardiovascular risks as people who light up each and every day, according to a new study.
“Our study shows that [social smoking] is a big deal. It is a modifiable behavioral risk factor that leads to adverse effects on the cardiovascular system,” said study author Bernadette Melnyk, PhD, RN, dean and professor of the College of Nursing at The Ohio State University.
The study did not include risks for cancer or lung disease.
Social smoking health hazards
Researchers screened more than 39,000 people from 2013 to 2016 for risk factors of cardiovascular disease such as smoking status, body mass index (BMI), blood pressure, and total cholesterol level.
They also asked the participants their age, gender, race/ethnicity, and other measures.
People in the study were also asked to identify as a nonsmoker, current smoker, or social smoker. The latter was defined as “an individual who does not smoke cigarettes on a daily basis but who smokes in certain social situations on a regular basis.”
This was part of the Million Hearts educational program, a five-year initiative to improve cardiovascular health co-led by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services.
Researchers found that the rates of high blood pressure and cholesterol were similar among current smokers and social smokers, after taking into account demographics and other health measurements.
“There was absolutely no statistical difference in high cholesterol and blood pressure between the social smokers and the regular smokers,” said Melnyk.
Compared with nonsmokers, social smokers were more likely to have high blood pressure or elevated cholesterol.
And social smokers were just as likely as current smokers to have these risk factors for cardiovascular disease.
This fits with other research that found that even occasional cigarette smoking can affect the functioning of arteries in healthy people.
Cardiovascular disease remains the leading cause of death in men and women in the United States.
It is also preventable with simple lifestyle changes — eating better, exercising more, quitting smoking — and managing cholesterol and blood pressure levels.
“Eighty percent of chronic disease — including heart disease — is totally preventable with some simple lifestyle changes,” said Melnyk. “It’s simple, but it’s not easy, because we’re talking about behavior changes.”
The study was published May 2 in the American Journal of Health Promotion.
Targeting social smokers
About 17 percent of study participants identified as smokers. This is similar to the adult smoking rate reported by the CDC.
More than 10 percent of participants were social smokers.
Social smoking was higher among Native Americans, Hispanics, multiracial Americans, and African-Americans.
Men were more likely to be social smokers than women. Also, social smoking was highest among 21- to 30-year-olds, followed closely by 31- to 40-year-olds.
Researchers say that by asking people “Are you a smoker?” or “Do you smoke?” healthcare providers may not be catching people who are social smokers.
Which is a missed opportunity to educate people about the risks of even occasional smoking, or help them give up tobacco before they become addicted.
“So many people try to stop smoking,” said Melnyk, “but it takes, on average, seven to 10 times before somebody’s actually able to stop.”
Some research suggests that social smokers may not become dependent on nicotine.
But a 2003 study in adolescents found that nicotine dependence shows up even in teens who only smoke occasionally, and increases with the frequency of smoking.
To better target social smokers, researchers recommend that healthcare providers ask more focused questions, such as: “Do you ever smoke cigarettes or use tobacco in social situations such as at bars, parties, work events, or family gatherings?”
However, doing a better job of identifying people who are at risk of cardiovascular disease is only one part of the solution.
“If you look at all causes of death and disease, behaviors are the number one killers of Americans,” said Melnyk. “We need to focus more on prevention, more on healthy lifestyle behaviors.”