A Straight Dope Classic from Cecil's Storehouse of Human Knowledge

Does smoking have any health benefits?

February 3, 1995

Dear Cecil:

We all know smoking cigarettes can kill you, but it seems to me that, as with most vices, there's a difference between use and abuse. People who drink too much destroy their livers, but people who have one drink of red wine per day actually help their hearts. I'll gladly accept the fact that smoking several packs a day is harmful, but what about having only three cigarettes a day, one after every meal? Does it really do any harm? Is there any chance it's actually good for you?

Cecil replies:

Well … I hesitate to mention this. But after years of research saying that smoking was the worst threat to public health since the plague, several recent studies suggest it may have at least one health benefit: it prevents or at least slows the onset of Alzheimer's disease. For obvious reasons these reports have been accompanied by a certain amount of embarrassed hemming and hawing. From a big-picture standpoint smoking is definitely bad for you, and nobody wants to give people an excuse to do more of it.

Still, facts are facts. I quote: "A statistically significant inverse association between smoking and Alzheimer's disease was observed at all levels of analysis, with a trend towards decreasing risk with increasing consumption" (International Journal of Epidemiology, 1991). "The risk of Alzheimer's disease decreased with increasing daily number of cigarettes smoked before onset of disease. … In six families in which the disease was apparently inherited … the mean age of onset was 4.17 years later in smoking patients than in non-smoking patients from the same family" (British Medical Journal, June 22, 1991). "Although more data are needed … [an analysis of 19 studies suggests] nicotine protects against AD" (Neuroepidemiology, 1994). Nicotine injections significantly improved certain types of mental functioning in Alzheimer's patients (Psychopharmacology, 1992). One theory: nicotine improves the responsiveness of Alzheimer's patients to acetylcholine, an important brain chemical.

I know, I know. Now that chimney at work will claim he's keeping himself (and due to secondary smoke, you) from going senile. Tell him it's a little early to start gloating. Some of the research is contradictory. At least one scientist thinks smokers are less likely to develop Alzheimer's mainly because they die of smoking-related diseases first. Smoking isn't like low-to-moderate alcohol use, which is probably harmless and may even be beneficial. Although the data is unclear, many believe the relationship between smoking and disease is linear: the more you smoke, the greater your risk — but any smoking presents some risk. Right now the only known benefit of smoking is a societal one: if the heavy smokers die young, they won't deplete the retirement funds for everybody else.

Smoking is good for you

Dear Cecil:

First off, as a loyal fan I acknowledge your omniscience, so this is not meant to be taken as a correction at all, since you are truly incorrigible. However, you may want to reassure the reader looking for advantages of smoking that a form of inflammatory bowel disease called ulcerative colitis is thought to be prevented by smoking. Relapses of this disease, marked by weeks of bloody diarrhea, are frequently provoked by suddenly giving up smoking. Not that this would make a good ad campaign for the folks at RJR, since ANOTHER form of inflammatory bowel disease called Crohn's disease, with only slightly different symptoms, occurs mostly in smokers.

Cecil replies:

Bummer about the Crohn's disease. Think of the great cigarette ads you could write:

SMOKE SARCOMAS
Look sharp, feel sharp
… and avoid weeks of bloody diarrhea

Anonymous also sent me a reference to a medical-journal article titled "Beneficial Effects of Nicotine" (Jarvik, British Journal of Addiction, 1991) that summarizes the many positive aspects of this wonder drug. "When chronically taken," it says here, "nicotine may result in: (1) positive reinforcement [it makes you feel good], (2) negative reinforcement [it may keep you from feeling bad], (3) reduction of body weight [by reducing appetite and increasing metabolic rate], (4) enhancement of performance, and protection against: (5) Parkinson's disease, (6) Tourette's disease [tics], (7) Alzheimer's disease, (8) ulcerative colitis and (9) sleep apnea. The reliability of these effects varies greatly but justifies the search for more therapeutic applications for this interesting compound." Yeah, and what other medical miracle lets you blow smoke rings?

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