The negative health effects of cigarettes are well known, but many people don’t realize the significant link between pancreatic cancer and smoking.

Smoking cigarettes can have a negative impact on your health. There’s no getting around it — decades of research show smoking affects much more than just your lungs.

Cigarette smoking affects almost every organ in the body, and the pancreas is no exception. If you smoke, your risk of pancreatic cancer is double that of people who’ve never smoked.

Approximately 25% of pancreatic cancers are thought to be caused by cigarette smoking.

Childhood exposure to secondhand smoke, the use of cigars, and smokeless tobacco can all also increase your risk.

According to a 2020 pancreatic cancer study, tobacco type and habit characteristics do influence your chances of developing pancreatic cancer, but the risk remains higher overall for smokers compared to non-smokers.

Smoking black tobacco products versus blond tobacco products, inhaling into the throat or chest (instead of just the mouth), and using non-filtered cigarettes were associated with the highest pancreatic cancer risk in the research.

Your pancreas is an organ that has both exocrine and endocrine functions. It helps regulate energy consumption and metabolism and is responsible for secreting important digestive enzymes (exocrine function) and hormones (endocrine function) like insulin and glucagon.

The exact pathology behind how smoking leads to pancreatic cancer is still being deciphered, but research indicates that cigarette smoking alters both the function and structure of the pancreas.

Carcinogens (cancer-causing substances in cigarettes) can stimulate inflammatory processes, abnormal cell growth, and fibrosis.

These molecular changes ultimately cause the enlargement of pancreatic glandular tissues and a variety of cellular mutations that progress to pancreatic cancer.

Approximately 90% of pancreatic cancers are ductal cell adenocarcinomas that originate in the exocrine pancreatic gland tissue — the tissue primarily affected by smoking.

Endocrine vs. exocrine

The pancreas is an organ with both endocrine and exocrine functions.

Endocrine glands secrete substances directly into your bloodstream, while exocrine glands deliver substances through a system of ducts.

Was this helpful?

Does smoking damage the pancreas?

Smoking doesn’t just inflame or aggravate your pancreas. The changes at the cellular level cause damage that can lead to fibrosis or scarring of the tissue.

While not all of the damage that occurs will progress to cancer, pancreatic changes can negatively affect your health in other ways.

Smoking may have a diabetogenic effect on the pancreas, for example. It can suppress insulin hormone release and increase glucagon expression. These factors can contribute to systemic glucose intolerance.

In addition to cancer, pancreatic fibrosis may cause chronic pancreatitis, a painful inflammatory condition of the pancreas that can permanently alter the organ’s function and structure.

Smoking not only increases your risk for pancreatic cancer, but it also affects your mortality rate.

A 2017 analysis reported that still smoking at the time of a pancreatic cancer diagnosis is associated with lower pancreatic cancer survival rates compared to never-smokers and those who had quit smoking before being diagnosed.

According to a 2019 meta-analysis, smoking — past or present — is associated with an elevated risk of all-cause mortality when living with pancreatic cancer.

Your risk for pancreatic cancer starts to decrease once you’ve stopped smoking.

A meta-analysis from 2018 found that risk rapidly declines after you quit, but it takes up to 20 years to return to that of nonsmokers.

Smoking is a controllable risk factor of pancreatic cancer, meaning that you can control or influence it. Other controllable risk factors include:

Not every risk factor can be controlled. Unchangeable features associated with higher pancreatic cancer risk include:

  • being assigned male at birth
  • having a Helicobacter pylori infection
  • being over the age of 45 years
  • having a relative diagnosed with pancreatic cancer
  • being African American
  • living with certain inherited genetic syndromes
  • chronic gene-related pancreatitis

A limited number of studies have shown that alcohol consumption, poor diet, and physical inactivity may also contribute to pancreatic cancer risk, but more research in these areas is needed.

Smoking is considered a major risk factor for pancreatic cancer. It can double your risk for this type of malignancy and can contribute to worse outcomes after diagnosis.

However, smoking is a controllable risk factor. If you stop smoking, your pancreatic cancer risk starts to decline. The sooner you stop, the sooner you can hit that 20-year mark where your risk will likely go back to that of nonsmokers.

Not everyone who smokes will develop pancreatic cancer, but smoking can still cause major, possibly irreversible, damage to your pancreas.