Single cigarette takes 20 minutes off life expectancy, study finds | Hacker News Reader

Single cigarette takes 20 minutes off life expectancy, study finds

theguardian.com

38 pointsisaacfrond85 comments

It can't possibly be linear like that, right?

Also, I swear the mechanism behind smoking causing cancer is that cells have a different division mode for rapid healing and it's more prone to copying errors than normal cell division. Some of these copying errors break the replication inhibition mechanism, and then you have the accepted thing where some errors are caught by the immune system and eventually you get unlucky and some aren't. This pattern applies to every cancer that I know of (where healing in the case of smoking is tiny burns healing over and over and over again).

I can well imagine a (first order) linear effect.

Inhaling toxic fumes gives a probability p that a cell is harmed into a cancer cell. The probability of a hit after n trials equals 1-(1-p)^n. First order approximation (this is the Binomial approximation), this equals n*p. This is accurate for small p and large n, exactly the situation smoking would be in.

Seems likely there are cleanup and repair mechanisms in play and outpacing those mechanisms would create a nonlinear threshold effect.

Another millennial lost in make believe 8-/

Those are very nice numbers! It's so neat and tidy! It's also a complete divergence from physical reality. You know, that boomer land where old people yell at the cloud?

For starters, I'm an advocate of total tobacco abstinence. I watched so many people shrivel up and die from tobacco as I grew up in the south, that I would never ever be a user.

Even the people that I know who are still users basically say they would really like to quit, but they're just too addicted. The withdrawal is just too intense and long lasting. One friend's mom quit because of advancing emphysema, she said she craved a cigarette every day for the remaining 10 years of her life.

Tobacco has a withdrawal on par with heroin, but you don't even get high from it, you just feel a relief from the withdrawal after using. It's one of the most insidious drugs of compulsion known to man, which is why it's such a commercial success.

But if each cigarette takes 20 minutes off of a persons life, I know a few people who should have died in the 1800s.

Almost nothing in the natural world is a linear phenomenon.

Actually, doesn't it have to be linear?

I'm having trouble looking up the exact study, the link they provide doesn't actually link the study.

But if I were to structure an observational smoking study, I basically track smokers vs non-smokers from the same population. Hope that my n is big enough and then simply track years non-smokers lived longer vs number cigs smoked.

Thus linear.

Help me - because I can't imagine a different way to run this.

In medicine is often a threshold effect. Only if you cross some threshold, harm is done.

I can not imagine that someone who smokes a few cigarettes in their 20s loses the same per cigarette as someone who smokes for years.

>I can not imagine that someone who smokes a few cigarettes in their 20s loses the same per cigarette as someone who smokes for years.

Realistically even in a large enough sample set you won't see a "jump" or "cliff". It'll just look like blurry data.

At some point, you'll be like obviously this is making a difference, but it'll be this very wide band and putting drawing a line will never be right. You'll end up saying something like >500-12,000 smoked means X minutes per cig.

The band will be so sloppy it's better to just go linear and say an overly simplistic answer.

To be more precise: It is not so much a (dose) threshold but how much margin/reserves your body still has.

For example kidney injury is progressive, and by the time the kidney's functional reserve is exhausted, things will remain bad until death or kidney transplant.

Also for diseases like HIV/AIDS, the cognitive reserve influences how long it takes until HIV associated dementia sets in.

Tobacco is quite interesting. It's not enjoyable. I don't know anyone who enjoyed it the first times they smoked. It takes efforts to get addicted. But once people are, it's extremely hard to quit, and lead you to an early death with quasi-certainty.

French author Michel Houellebecq refers to it ironically as a "perfect" drug, in the sense it doesn't provide pleasure, only addiction.

Good job US to manage to reduce their use. In my country, it drives me crazy that we're not able to prevent kids and teenagers from smoking, because this is the root of the problem. It's a huge cost for them to pay, and society as whole in term of healthcare.

I've smoked intermittently for years. Whenever I started back, it was triggered by something stressful. I don't know if it is the addiction lurking around even after not smoking once in 5 years. It is extremely calming in those stressful situations.

And as ex smoker, I find it interesting it's not the smoking itself that was 'stress reducing' for me. But those 5 minutes I would make free for myself to do nothing (smoke) and just think.

I once read that smoking is a bit akin to a guided breathing exercise in that way - during those 5 minutes you breathe consciously and in a more controlled manner than usual. I don’t know if its actually true but it always made sense to me.

It’s not tobacco (Which I’m convinced is not all that bad when stripped of all the processing and chemicals) but it’s whatever they are putting in the cigarettes.

Like about of folks here I enjoy a cigar from time to time (1-3 times a year) and suffer none of the addiction problems. The taste and aroma is legitimately nice, like having a nice cup of coffee or a scotch. But after smoking one there is no desire to have more and I’m usually smoked out for a few months to a year.

It's not just "whatever they are putting in" that makes them addictive or pleasurable. There's just something about inhaling through a little stick and breathing out smoke/vapour.

I almost got addicted myself when someone gifted me a nicotine-free e-cigarette. At first it was a curiosity, then I ended up puffing it regularly. When it ran out my mind went immediately to acquiring more, but luckily I was able to catch what had happened and learnt something about cigarettes.

> There's just something about inhaling through a little stick and breathing out smoke/vapour.

i think it might be related to the same breathing exercises some people do to control the vagus nerve, with the added help of some mild stimulants

https://en.wikipedia.org/wiki/Vagus_nerve#Stimulation

slow breathe in (through some restrictor), small hold, then steady release

I wonder if there is a "sports stick" which doesn't use any vapor altogether and is just a stick with a paddlewheel which just makes inhaling harder lol

I use nasal snuff, it seems much less addictive.

It’s tobacco - nicotine is highly addictive.

I never smoked normal cigarettes only used self-rolled tobacco without additives and I am still addicted.

Smoking cigars is different since they take out most of the nicotine carrying parts - at least that’s how a Cuban cigar maker explained it to me.

Nicotine is addictive, but not for long - somewhere between 3 days and one week. I don't smoke cigarettes anymore, but switched to vaping. Despite using no-nicotine liquid for ages, I still have cravings - not at all for real cigarettes, just for inhaling. The psychological addiction is far greater than the physical one.

So it is addictive long-term, the addiction is just psychological and little to no physical side effects. It still has the highest psychological addiction of any drug I tried (never used opiates which is the one that is more addictive imo)

I hear from people who did both that smoking is harder to quit. It's just not the nicotine itself, from experience.

> It's not enjoyable.

People wouldn't get addicted if it wasn't enjoyable. People's first experience with smoking cigarettes might not be enjoyable because cigarettes taste, smell, and feel awful, but the nicotine inside them is so incredibly enjoyable that it gets people to ignore the awfulness of everything else.

I've quit now, but I've used nicotine for years. In the first few months it gave me a rush, it made me more alert, energetic, and provided a distinct boost in concentration.

Some (but not all) of those positive effects wore off after a couple of years but I always felt like I was getting something in return. It's been a year since I quit and while withdrawal symptoms (awful, by the way, I definitely don't recommend starting!) have gone away and I don't get any cravings anymore, I still notice a slightly reduced level of functioning in myself. It's slightly harder to get started on things, stay focused, and get them done.

Denying this reality by pretending that nicotine is just universally bad and doesn't provide any form of pleasure is how you get teenagers to ignore everything else you said when they try it and find out that it does all of those things.

Teenagers smoke for social reasons. It's very rare to see adults picking up smoking. Also, I'm not sure how many cigarettes you need to smoke before you get a good feeling out of it, but probably quite a lot.

Eventually, nicotine relieves the discomfort of addiction, which is what people conflate with pleasure.

It's true that after years of use (almost exclusively vaping) nicotine didn't make me "feel good" anymore (like it did in the beginning), no matter how much I used, but it still made me function at a slightly higher level which indirectly made me feel better.

> Tobacco is quite interesting. It's not enjoyable.

I remember the first time and it was enjoyable, a very pleasant feeling. I didn't need to try to like it. I was never addicted either, I just liked it when I was out once a week. Then I didn't smoke any for months due to being busy with other life stuff and the next time I tried it made me vomit and that was that.

Tobacco is definitely enjoyable - just because you have to acquire a taste doesn’t rule it out.

Many things you have to acquire a taste for - personally for me that was any kind of alcohol, olives, raw fish, spicy food, oatmeal or even coding. None of these things were enjoyable or did provide pleasure the first times i experienced them - now i find it hard to imagine living without.

> I don't know anyone who enjoyed it the first times they smoked.

Cigars and pipes have quite a nice taste and aroma. I don't have any memory of not having liked it, so I must have enjoyed it the first time.

Cigarettes, on the other hand, did indeed suck so much that I never got into them.

> Cigars and pipes have quite a nice taste and aroma.

They really don't

I’m really not a fan of smoking cigarettes at all (although cigars are nice every once in a while), but I do wonder if a study has ever incorporated the social aspects of smoking. Social life does have an effect on life expectancy, although probably not enough to make up for the loss of life caused by smoking.

The only real appeal of smoking to me was the fact that one has an instant social situation with other smokers. Nowadays, non-smoking strangers with time to kill end up staring at their phones. Although I wonder if smokers also do the same thing…

Well, to have a full understanding you should also factor in the life loss by second hand smokers who involuntarily breath smoke

And let's not forget the social aspects of being second hand smokers connecting emotionally with others in the same unfortunate position and whom they would not connect with otherwise :)

I was referring to the life lost by the individual smoker, not life lost at large.

How would you do this? You can't A/B test an individual's death.

I guess you could have smokers self-evaluate their social lives and see if any patterns emerge. “When you smoke, do you do it alone or with others?” Etc.

as someone that quit almost 1 year ago, I can tell you that yes smokers could stare at their screen instead of talking to you when going out to have a puff

These studies are correlations that ignore complex interactions. Something pushed that guy to smoke and same something also makes him likely to do other things culminating in earlier death. Another guy smokes all his life and lives into 90s with no issues because there was no "something". Another guy dies of suicide in his 30s because of loneliness because he did not have the excuse of cigarette to connect with people

Smokers have higher suicide risk than non-smokers.

It has been known for decades that smokers have a "smoker personality" which differs from non-smokers. In recent years some evidence emerged that smoking is the cause of this rather than vice versa.

https://www.sciencedaily.com/releases/2014/07/140715141355.h...

Yes but I am not sure you appreciate the point about cause and effect I made

? The second part of my reply was about cause and effect.

My reading comprehension. Oops.

There are some good points regarding policy, like if there are anti smoking policies then suicide risk is lower.

I think there are two kinds: chill balanced smokers and smokers who think it is bad for them and use it to show slow suicide. So I am not surprised smoker suicide rates are higher. Anti smoking policies reducing suicide is interesting. could be preventing a mild suicide from starting helps it not graduate to more serious. Mental health decline after starting smoking != mental health decline from nicotine, I bet it is real and big part of it is nicotine but doing daily and visibly something much of society frowns upon probably "helps". And also just knowing that you are killing yourself, if you are that kind of smoker

Them saying that drugs can cause depression is basically saying nothing (basically same as "not using drugs can cause depression").

It's confusing that Serbia beats almost everyone by amount of smokers, it is the most smoke filled place I visited but it is not even in the top in https://www.wcrf.org/preventing-cancer/cancer-statistics/lun......

Sorry I noticed the reply only now.

A similar thing to what you said about smoking in Serbia is observed with alcohol: Within a society, the earlier someone gets into contact with alcohol, the poorer the outcomes.

https://pmc.ncbi.nlm.nih.gov/articles/PMC2741422/

However there are societies where even children are given alcohol (like Italy) and where alcohol related disorders are much less frequent than in societies which strictly limit alcohol to adults.

In that case, probably social norms which help prevent such disorders have a larger effect than the drinking age. However such would be difficult to imagine for smoking.

> there are societies where even children are given alcohol (like Italy) and where alcohol related disorders are much less frequent than in societies which strictly limit alcohol to adults.

True. Like in Russia normally a child drinking any alcohol is super bad and unacceptable. Many places don't sell alcohol after certain time of day. And people in russia drink less in total than in many european countries. But they do "risky drinking pattern".

I knew a British guy who can start before noon and drink till night while maintaining sanity. he is strategic, drinks weak ass beer etc. And yes he had a "drinking problem". But a russian with the same problem would get shitfaced and completely out of control by mid afternoon... and I hope you don't meet him on the street, if he doesn't like how you walk he can murder you and not remember it in the morning. I'm not joking.

> However such would be difficult to imagine for smoking.

So I'm not totally sure it's too different. While smoking is bad I think it can be a disorder or associated with a disorder (call it "risky smoking pattern") however it can also be a mostly neutral habit. Less stress, less harm.

Also, a thing I've recently read

> People with Schizophrenia appear to have a high rate of self-medication with nicotine; the therapeutic effect likely occurs through dopamine modulation by nicotinic acetylcholine receptors

https://en.wikipedia.org/wiki/Dopamine_hypothesis_of_schizop...

If schizotypy is a spectrum and many people are somewhere on it then nicotine can make someone feel saner. (Of course smoking is probably not the best way of getting nicotine)

Are you arguing that people who smoke are simply predisposed to behaviours that cause lung cancer regardless of whether they smoke?

Smoking seems to cause lung cancer in some people but we don't know what would happen to those people if they didn't smoke. It's likely in some people smoking happens with other habits that would cause one issue or another but in other people it's not that. The studies that try to generalize smoking to life expectancy seem questionable.

From the recent time I was on a construction site: all the carpenters and drywallers etc all went for smoke breaks all the time, use of protective gear was infrequent. This was only one site I saw others with better habits.

No, he’s not arguing about causation but about correlation. Confounding variables. For example, where I live cigarette use seems related with social class (being more prevalent with the poorer part of our population). That can correlate with living and working conditions, which can impact everything else

> These studies are correlations that ignore complex interactions.

Yes they have to. There's no way to do it otherwise and get any meaningful data. You have to get `n` to be very large.

Jeanne Calment gave up smoking at 117 [0].

Number of people who also lived past 117 is three [1].

Sarah Knauss had a fondness for sweets and hated vegetables [2] lived to 119.

Edit: Merely a curio of the people who held number 1 and 2 position of verified oldest people for over two decades.

Apologies, if the post suggested otherwise.

[0] https://en.wikipedia.org/wiki/Jeanne_Calment#Health_and_life...

[1] https://en.wikipedia.org/wiki/Oldest_people

[2] https://en.wikipedia.org/wiki/Sarah_Knauss#Health_and_lifest...

It’s quite obvious that an incredibly small sample, hand chosen, will be biased.

These kinds of announcements are quite misleading IMO. It’s not like smoking a single cigarette immediately takes off 20 minutes, it’s a cumulative effect caused by years of heavy smoking. It’s not particularly meaningful to average that out over the number of cigarettes smoked.

Thats over-exaggerated and non linear. My mother smokes 40/day but let’s say 30 because it was’t always so much. How many days lost per year?

3036520/60/24 = 152days

She smoke since she was 20 and she’s 64 now. How many years lost in total?

(64-20)*152/365 = 18years

Life expectancy for women in my country is 85yo. How many years left?

85-18-64 = 3years

Oh shit I really hope that’s over exaggerated. I should call her now to tel her I love you. And stop smoking me too. Oh shit I’m crying now (for real)

That is not now life expectancy works. You cannot take life expectancy at birth and apply it to adults by subtracting past years of life, because doing so ignores all the people that died in the meantime from related or unrelated causes.

Rather you have to take remaining life expectancy at any given age and estimate from there how likely death is within 1 or 5 or 10 years.

Also relevant is other existing health issues like COPD.

https://openi.nlm.nih.gov/detailedresult?img=PMC2672796_copd...

That make sense. Also the average life expectancy of a population is calculated with smokers in the cohort I guess.

Nohavica's theory of alcoholic mountain comes to the rescue:

As you are drinking, you are climbing your alcoholic mountain. While you climb up, everything is ok. Once you crosses the summit and starts going down, nobody can help you. Doctors won't help you, your friends won't help you, you won't help yourself. So what's the problem? Nobody knows how tall is their mountain! So your uncle was drinking whole life and he was fine. Yes, because his mountain was very tall.

The scene is from the mocumentary "Year of the devil": https://www.youtube.com/watch?v=FzEgqhMpk5c

Thanks. Nice story but I’m not sure to grasp the inner meaning. I’ll try to translate the video you shared.

I wonder how long my great grandad would have lived if he hadn't smoked? He started smoking at 10 and died at 90.

Their math says roughly to 109.

That's not how expectancy works. Perhaps if you had n great grandads, with n approaching infinity, on average they would make it to 109. But there is no telling for your own particular grandad.

Hm Is the 20 minutes/cigarette solid then?

My grandfather smoked packs of cigs/day from his 11th when he started working his parents fields. My mother never saw him without a sigaretten in his mouth. Died obese and still smoking at 96 suddenly (no known health issues). Seems a lot longer, but of course he wouldn't. And a lot less happy I think: the guy never stopped smiling and cracking jokes and singing; he liked his drink, smoke and a lot of food; if he would have to let those go, I think it would've made him very different. Will never know of course.

All of my grandparents lived well into their 90s. Mediterranean people, they loved good food and good wine (a bit of smoking too for some of them), fought/survived WW2, worked fairly rough jobs after, no exercise in the modern sense (eg cardio/strength training).

I have a sneaking suspicion our generation won't make it as far as them (and a few of my family members in the generation after have died in their 70s already). A part of me wants to say "chemicals and microplastics" but my grandpa worked in factories with some pretty nasty chemicals so that can't count for nothing (and they drove cars with leaded fuel too).

Maybe it is in no small part that they spent more time outdoors, and more time socializing? Or maybe it's all just randomness and none of that has any rhyme or reason.

Life stress, and overall more active.

Haha, yeah my grandfather, his brothers and his son sawed asbestos plates to make roofs from for many years. I have no clue how that works. But worked outside further, walked everything etc.

If someone can't get off nicotine, they should switch to smoke-free alternatives such as snus or e-cigarettes.

Does that include the 20 minutes it takes to smoke a cigarette? So, the net loss could be 40 minutes?

Are you saying it’s a solution to my lack of retirement plans then?

Putting the cost of a pack of cigs in a retirement account everyday would be a better plan given their price.

In other news "Popular online media outlet publishes story about stopping smoking to generate engagement in time for New Year resolutions. Written in a way that sharing it with family members seems caring instead of pushy".

I did get a reasonable article from chatgpt with the prompt "Write a 500 word article about stopping smoking to in time for New Year resolutions. Written in a way that sharing it with family members seems caring instead of pushy. Make it sound like it has a strong medical and scientific foundation. Include statistics about impact on life expectancy". They don't need to have their best journalists around this time of year.

It got engagement and clicks from me.

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