The Centers for Disease Control and Prevention (CDC) yesterday told 1/4 pack per day smokers that they might as well smoke 2 packs per day. Specifically, the CDC informed smokers that smoking 5 cigarettes per day offers no health advantages compared to smoking 40 cigarettes per day.
As quoted in an article in the Deseret News, a CDC spokesperson stated: "Just reducing the number [of cigarettes smoked per day] doesn't reduce health risks. You have to quit completely."
So according to the CDC, reducing the number of cigarettes smoked per day doesn't reduce health risks. That indeed implies that smoking 2 packs of cigarettes per day is no more harmful than smoking 1/4 pack per day and that reducing consumption from 40 cigarettes per day to just 5 cigarettes per day offers no health benefits.
The Rest of the Story
There's only one minor thing wrong with the CDC's statement ...
... It's not true.
Anyone who, like myself, has treated smokers with respiratory disease and listened to what they had to say can tell you that most (if not all) heavy smokers who drastically reduce their cigarette consumption experience substantial improvement in their respiratory symptoms. Moreover, such smokers experience objective improvement in lung function, as measured by spirometry.
In fact, Dr. Riccardo Polosa and colleagues demonstrated this finding specifically among smokers who cut their cigarette consumption by switching partially to e-cigarettes. Even among dual users (of both cigarettes and e-cigarettes), there was a substantial improvement in both respiratory symptoms and clinically measured lung function.
While it is true that reducing the amount one smokes does not decrease the risk of heart disease (because the atherosclerotic effects of tobacco smoke are saturated at a very low dose), the same is not true for respiratory disease. Basically, in someone with reduced lung function, every cigarette smoked contributes to further impairment. Smoking 40 cigarettes per day is going to cause a lot more impairment than smoking 5 cigarettes per day. And if a smoker is able to cut down from 40 cigarettes per day to 5 cigarettes per day, it clearly does offer health benefits over continuing to smoke 2 packs per day.
Is it better to quit smoking completely than to become a dual user of e-cigarettes and tobacco cigarettes? Of course! Should we encourage smokers to stop smoking completely instead of using both e-cigarettes and tobacco cigarettes? Of course! But this doesn't mean that it is acceptable to lie to people and tell them that substantially decreasing their cigarette consumption offers no health benefits over continuing to smoke heavily.
There is an additional health benefit of substantially cutting down on the amount smoked, beyond the improvement in respiratory symptoms. Drastically reducing cigarette consumption decreases the level of addiction to smoking and has been shown to make it easier to eventually quit smoking completely. Therefore, the claim that CDC is making to smokers is not only false, but it is irresponsible as well.
This public statement could very well cause many smokers who are thinking of substantially cutting down on the amount they smoke not to do so because they figure that there is no point in reducing consumption if it offers no health benefits. To the many thousands of dual users out there who have made great progress by sharply reducing their cigarette consumption, this false information could actually deter them from vaping and result in their returning to full-time smoking. After all, what is the point of vaping most of the time instead of smoking if you are just as healthy smoking all of the time?
There are many vapers who are in fact dual users, but they only smoke about 2-3 cigarettes per day. Would it not be a shame if these vapers, who have obviously made great progress towards quitting and have experienced great improvement in their respiratory symptoms return to full-time cigarette smoking because the CDC told them that cutting down to 2 cigarettes per day offers no health benefits over smoking 40 cigarettes a day?
Let me close by pointing out one thing that is apparently not clear to the CDC:
It is not OK to lie to the public!