Hello Dr. Kadile, I have a friend who only smokes cigarettes when she drinks. She says she is not a smoker, because she doesn’t smoke regularly. This is still bad for you, isn’t it?
-Tracy, La Quinta

Tracy, I frequently encounter a similar situation when I am obtaining a medical and social history from a new patient when I ask them if they have ever smoked. The most common response is that they don’t consider themselves smokers because they only smoke when they have a couple of drinks. What if you go out and have a few drinks every weekend or several times a week? The simple truth is, whether you smoke one or more cigarettes regularly, you are a considered a smoker.

The Center for Tobacco Control Research and Education at the University of California, San Francisco, reviewed studies of light and intermittent smoking, along with the Surgeon General’s report on smoking. They put together a list of health hazards associated with social smoking:

heart disease
weakened aorta (the main artery from your heart)
premature death from cardiovascular disease
lung, esophageal, stomach and pancreatic cancer
respiratory tract infections
fertility problems
slower recovery from injuries
poorer health related quality of life

Of course the risk of these health hazards increase the heavier you smoke, but I have seen patients who frequently get sick, have long lasting coughs and develop chronic bronchitis because they only “smoke when I’m drinking”.


An interesting thing about social smokers is that they don’t seem to be drawn to smoking more by the nicotine, which causes smoking addiction. Daily smokers continue to smoke and increase their cigarette use due to the strong nicotine addiction. They are usually not in denial about their smoking and the associated adverse health affects. Social smokers tend not to be addicted to the nicotine, but drawn by the “social” aspect of smoking and the short term high of the carbon dioxide and nicotine. Social smokers tend to be in denial about the adverse health effects of smoking because they don’t consider themselves regular smokers.

The bottom line is: If you smoke at all, you are exposing yourself to a highly toxic poison that increases your risk for cancer and heart disease.

So Tracy, you can tell your friend that social smoking is still bad for her. If you are around your friend when she smokes, then you too are at an increased risk for cancer and heart disease because of the dangers of second hand smoke. Smoking is bad, period.