Smoking even small amounts of tobacco causes significant cardiac risk, a recent study has concluded. The findings prompted the British Medical Journal (BMJ) to say that there is no safe level of smoking and that “smokers should aim to quit instead of cutting down.”1,2

Smoking just one cigarette a day has a much higher risk of coronary heart disease and stroke than might be expected – around half the risk of smoking 20 cigarettes a day, said the researchers.

While a reduction in smoking will result in a proportionate reduction in the risk of cancer, this is not the case for cardiovascular risk. Men who smoked one cigarette per day had 46% of the excess relative cardiovascular risk for smoking 20 cigarettes per day, and an excess stroke risk of 42 per cent. This is “much higher than the expected 5%,” commented the BMJ.

The systematic review and meta-analysis found that the pooled relative risk for coronary heart disease among was 1.48 for men and 1.57 for women when smoking about one cigarette a day, and 2.04 for men or 2.84 for women for smoking 20 cigarettes a day.

When adjusted for multiple factors and ‘confounders’, the relative risk increased to 1.74(m)/2.19(w) for one cigarette and 2.27(m)/3.95(w) for 20 cigarettes respectively.