The Medical Minute: Health risks of smoking go beyond lung cancer

Doctors ask patients about smoking habits for the same reason they check weight, blood pressure, breathing and heart beat during a visit.

The answers – much like the results of the other checks – provide information that offers clues to overall health and risk factors. They can also guide treatment of existing health conditions.

“Doctors are there to improve your health, and cigarette smoking is probably the single most harmful thing you can do to your health,” said Jonathan Foulds, professor of public health sciences and psychiatry at Penn State College of Medicine. “It’s hard to find a part of the body not affected by it.”

While most patients know that smoking causes breathing problems and lung cancer, they may not be aware of the magnitude of the risk, or the other health problems it can cause.

“If you smoke a pack a day or more, your risk of getting lung cancer isn’t just one and a-half or double that of a nonsmoker,” explained Foulds. “It’s 20 times as great.”

Dr. Alexis Reedy-Cooper, a family medicine physician at Penn State Health Milton S. Hershey Medical Center, said smokers may not connect smoking to cardiovascular problems such as heart attacks and strokes, or other diseases such as Type II diabetes and cancer.

“You should let your dentist know if you smoke because he or she can take special care to evaluate you for tongue, head and neck cancers,” she said. “Dentists are often the first to detect those.”

Smoking is also dangerous for people who spend time with a smoker. Children who live in households with a smoker have an increased risk of developing asthma, ear infections and lung infections. Pregnant women who smoke put their unborn child at risk for complications and premature delivery.

Foulds said quitting smoking has a bigger effect on reducing risks for a heart attack than lowering high cholesterol or blood pressure so patients should expect their doctor to assess their smoking and advise on smoking cessation medicines just as they would prescribe medicines for hypertension or hypercholesterolemia.

Most patients expect doctors to ask about smoking, even if their answer hasn’t changed from their previous visit.

“It’s an addiction and tough to quit, but patients have more respect for their doctor when he or she asks about it and offers to help them quit,” Foulds said.

He encourages providers to talk about the subject in a positive way, outlining the health benefits, and look for ways to help a patient quit, whether it be counseling, medication or both.

“It’s not a question of whether they should quit – it is critical that they quit,” he said. “Smoking is a risk factor for so many things that it doesn’t make sense to wait.”

Reedy-Cooper said new guidelines also recommend that smokers get more frequent lung cancer screenings, so it’s important for patients to be honest about how much and how often they smoke.

“We’re not going to judge you,” she said. “We just want to help.”

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The Medical Minute is a weekly health news feature produced by Penn State Health Milton S. Hershey Medical Center. Articles feature the expertise of faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

January 31, 2018 Penn State Health News

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