It Is All About Risk
Most smokers when they light their cigarette are not thinking about the risk of smoking and the effects of their habit on their health. They know that this cigarette will not kill them, or the next. The effects of cigarette smoking are slowly cumulative. Of course the smoker can always quit, can not they? But it is generally some unspecified date in the future, as long as it's not now. The drug addict can make a thousand excuses why they can not quit smoking, just yet. Nicotine's hold is tenacious and do not expect it to let go easily. The smoker is in denial.
The risk of smoking is pushed to the back of the mind; it vanishes in a puff of smoke. Denial or not, the risk is real. The statistics do not lie; 1 in 2 lifelong smokers will die from their smoking habit. The bald statistics however do not tell the whole story. The overall risk is not the same as the individual risk of smoking. The individual risk of smoking is something different. An individual's risk of death through smoking is unknown. Many factors will influence individual risk. We are not all created equal and this is also the case with regard to the risk of smoking.
An individual's risk of contracting a life threatening smoking related disease is affected by a complex interplay of genetics and environment. For instance, in simple terms an individuals risk will be related to the amount smoked over time. The relative risk of contracting a smoking related disease would be greater for a 2 pack a day smoker, who has smoked for 40 years, than a half pack a day smoker who has only smoked for 10 years. Other environmental factors may also play a role. It is known that cigarette smokers exposed to asbestos will increase their risk of lung cancer.
Scientists are only now getting to grips with the role of genetics and the risk of smoking. This is where it starts to get really complex. Genetics determines so much about us; genetics influence our behavior. Smoking behavior is complex but genetics regulates that behavior to some degree. The number of cigarettes a smoker actually smokers is to a certain extent influenced by our genetic make up. Also, how addicted we become to nicotine is under genetic control. This is important because the degree of addiction determinates, to a great extent, how hard it will be to give up, and therefore absolutely will have an important bearing on the risk of smoking related disease. But genetics not only regulates smoking behavior it also shapes how our body reacts to cigarette smoke generated toxins. Chemicals in cigarette smoke damage cellular DNA and the damage increases over time. This is a critical point.
DNA damage equals genetic change and genetic change in a cell can lead to cancer. Individuals vary, at the cellular level, on how they respond to DNA damage. Everyone has mechanisms within the cell that are responsible for repairing genetic damage. Again we are all different in how effective our DNA repair processes are. Individuals with a reliably 'poor' repair process are at the greatest risk of accumulating genetic damage and extremely of developing cancer. Now this is where it starts to get scary. Researchers have recently identified genetic predisposing factors that not only make it likely that the carrier will be highly addicted to nicotine but also increases their risk of lung cancer; now that is a deadly combination.
The Lucky Few
There will be a few smokers out there, who by genetic fortune and chance of environment, will never suffer as a consequence of their smoking habit; their risk of smoking is zero. I suspect that this is rather a select group. The majority of smokers will suffer some ill health effects and 50% will be extremely killed by their habit. When we start to smoke the risk of smoking is not something that is likely to be a serious consideration. The vast majority of smokers start in adolescence. Potential risks from their smoking habit seem a long way off and after all, as we all know, the young are invulnerable.