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Smoking

MyHealth

Description: An in-depth report on the health risks of smoking and how to quit.

Highlights:

Overview:

  • Smokers lose 10 years of life on average from smoking-related illness.
  • Some 44 million people, or about 19% of adults in the United States, smoke.
  • Heavy smoking (pack a day) has been on the decline over the past few decades. Smoking cessation programs and smoke-free environments have played a role in the decline.
  • Despite this progress, as of 2011, over 9% of people who smoke consumed 30 or more cigarettes a day.
  • Thirty-six states and the District of Columbia have enacted laws banning smoking in restaurants, bars, and/or workplaces.

Smoking Cessation:

  • Quitting smoking can prevent or reverse many smoking-related illnesses.
  • Specially tailored online provider programs (WeBREATHe) can encourage clinicians to discuss smoking with children and adolescents.
  • Pediatric counseling and interventions are key to stopping smoking before it starts.

In Adults:

  • Interventions that combine medication with behavioral counseling (at least 4-8 sessions) are more effective than brief advice or usual care.
  • Electronic, online, and computer cessation programs have a small but important impact on cessation compared to no intervention or self-help materials. The relatively low cost of electronic interventions make the approach a good option.
  • All forms of nicotine replacement therapy (NRT), such as gum, patch, spray and tablets, can be effective in promoting smoking cessation. NRT increases the quit rate by 50-70% for at least 6 months or longer. Most of the research is focused on adults, but adolescents may also benefit from NRT.
  • Several small studies suggest E-cigarettes can help some people quit smoking, but other researchers worry that they may serve as gateway products leading to tobacco use. Because of safety concerns, the FDA has announced that it will regulate e-cigarettes in the same way that it regulates tobacco products.

New Research:

  • Men who are diagnosed with prostate cancer fare much worse if they smoke. Current smokers are more likely to have their prostate cancer return, and to die, than men who never smoked.
  • Exposure to smoke is dangerous during pregnancy, and even women who don't smoke themselves can suffer the harmful effects of cigarettes. Pregnant women who are exposed to secondhand smoke increase their risk of having a stillbirth by 23% and increase their baby's risk of birth defects by 14%.
  • Heavy smoking during middle age can lead to memory problems later in life. Middle-aged smokers are twice as likely as non-smokers to get Alzheimer's disease and dementia when they get older.

Screening:

  • Annual low-dose CT screening for lung cancer should be offered to current and former smokers who are between the ages of 55 - 74 years, have smoked at least 30 pack years, and have no history of lung cancer.
  • Chest x-rays should not be offered as a screening tool.


Introduction:
Smoking hazards

Just under 44 million people, or about 19% of adults in the United States, currently smoke, according to a 2012 report by the U.S. Centers for Disease Control and Prevention (CDC). Smoking rates dropped by nearly 1% -- or 3 million people -- between 2005 and 2010. No significant change occurred between 2010 and 2011, the last year for which figures are available.

Heavy smoking (a pack-a-day habit) is also down from a few decades ago. Back in 1965, close to 23% of Americans were heavy smokers. Today, only about 7% smoke 20 cigarettes a day or more. California has been especially successful at reducing heavy smoking rates, in part due to smoking cessation programs and smoke-free environments. Despite this progress, as of 2011 over 9% of people who smoke consumed 30 or more cigarettes a day.

These reductions in overall smoking are good news, but smoking is still a big health problem. It kills 443,000 people a year in the United States, accounting for nearly 1 out of every 5 deaths.

The addictive effects of tobacco have been well-documented. Tobacco is considered to be a mood and behavior altering substance that is abusable. Tobacco is believed to be as potentially addictive as alcohol, cocaine, and morphine. Tobacco and its components increase the risk for cancer (especially in the lung, mouth, larynx, esophagus, bladder, kidney, colon, pancreas, and cervix), heart attacks, strokes, and chronic lung disease.

Smoking in Childhood and Adolescence

Fewer teens are smoking today than in the late 1990s, but the decrease in teen smoking rates has slowed in recent years. In 2011, 23.2% of high school students used some form of tobacco product, down from 34.4% in 2000. Also among high school students, 15.8% were current cigarette users in 2011, compared with 27.9% in 2000.
The number of frequent smokers (defined as 20 or more cigarettes a month) dropped from about 13% in 1991 to 7% in 2009.

The younger children start smoking, the more likely they will smoke as adults. Smoking can become addictive very quickly. According to the American Cancer Society, the earlier you start smoking, the more likely you are to develop long-term nicotine addiction.

In the past, advertising played a major role in encouraging some teens to smoke. New regulations have made it much more difficult for advertisers to promote smoking to young people. However, scenes that show people smoking, often in a positive way, are still common in movies and television shows. This may be a major influence on the attitude toward smoking in children and adolescents.

Research has found that parents can discourage their children from smoking by:

  • Not smoking themselves
  • Telling their children they do not approve of smoking
  • Closely monitoring their children's television and music-listening habits
  • Being home for their kids and providing a structured home life

Doctors can also have a major effect on their young patients' smoking habits. However, less than half of teenagers say their doctors have ever asked them if they smoke (even though most teen smokers said they would admit to smoking if asked) or given them counseling on how to quit. Counseling may be of particular importance, considering that teens who smoke are more likely to attempt suicide than their non-smoking peers.

The Web-Based Respiratory Education About Tobacco and Health (WeBREATHe) program is an online training program for pediatric providers that can encourage clinicians to discuss smoking with their patients.

Gender, Age, and Ethnicity

AgeTotal
18 - 24 years18.9%
25 - 44 years22.1%
45 - 64 years21.4%
65 years and older7.9%
Source: CDC/MMWR Report 2012

While the percentage of adults over age 65 who smoke is lower than the percentage of smokers in other age groups, older adults usually have smoked for a long time (about 40 years) and tend to be heavier smokers, according to the American Lung Association. Because of this, older smokers are more likely to have smoking-related illnesses.

Among high school students (under age 18), Caucasians are more likely to smoke cigarettes than Hispanics and African-Americans. Asians in the US have the lowest smoking rates. The rates of smoking have not changed significantly since 2009.

Geography

In general, the rate of smoking is highest in the Midwest and South and lowest in the Northeast and West. Utah has the lowest smoking rate in the United States.

Educational Level

People who have not graduated from high school or received their General Education Development (GED) certificate are more likely to smoke than those who attended college. The lowest smoking rates are in people with advanced graduate degrees.

Psychological and Physical Factors

Men and women with mental or physical disorders are about 50% more likely to smoke than people without such illnesses. Factors that can influence smoking include:

  • Low self-esteem
  • Behavioral problems (in teens)
  • Depression
  • Schizophrenia
  • Physical disabilities

Having depression increases the likelihood that someone will smoke, and decreases their likelihood of quitting. Twice as many adults with depression are current smokers, compared to those without depression. The more severe their depression, the more likely people are to smoke.

Genetic Factors

Evidence strongly supports the idea that genes play a role in a person's dependence on nicotine. Researchers are now targeting specific genes that may be responsible for nicotine dependence. The same genes may be responsible for both nicotine and alcohol dependence.

Economic Factors

Some studies suggest that smoking becomes more widespread when it is cheaper to buy cigarettes. For example, states that have low taxes on cigarettes have a high proportion of smokers. Making it more expensive to smoke may reduce the number of smokers.



Nicotine Addiction:

Nicotine is the chemical in cigarettes that makes them addictive. About 85% of smokers are addicted to nicotine. Higher levels of nicotine in a cigarette can make it harder to quit smoking. The amount of nicotine in cigarettes has steadily increased in the past decade. Higher nicotine levels have been found in all cigarette categories, including "light" brands.

Some researchers feel nicotine is as addictive as heroin. In fact, nicotine has actions similar to heroin and cocaine, and it affects the same area of the brain as these drugs.

Depending on the amount taken in, nicotine can act as either a stimulant or a sedative.

Cigarette smoking produces mental effects very quickly. For example, it can:

  • Boost mood and relieve minor depression
  • Suppress anger
  • Enhance concentration and short-term memory
  • Produce a sense of well-being

Most smokers have a special fondness for the first cigarette of the day because of the way brain cells respond to the day's first nicotine rush. Nicotine, particularly in those first few cigarettes, increases the activity of dopamine, a chemical in the brain that elicits pleasurable sensations. This feeling is similar to getting a reward.

Over the course of a day, however, the nerve cells become desensitized to nicotine. Smoking becomes less pleasurable, and smokers may need to increase their intake to get their "reward." A smoker develops tolerance to these effects very quickly and requires increasingly higher levels of nicotine.

Smokeless Tobacco

Smokeless tobacco, also called spit tobacco, includes chewing tobacco (dip and chew), tobacco powder (snuff), as well as flavored tobacco lozenges. These products also contain nicotine.

With smokeless tobacco products, tobacco is absorbed by the digestive system or through mucus membranes. Smokeless tobacco contains at least 28 cancer-causing substances, and is not a safe substitute for smoking cigarettes or cigars. According to the National Institutes of Health, chewing on an average-sized piece of chewing tobacco for 30 minutes can deliver as much nicotine as smoking three cigarettes.

Smokeless tobacco is addictive, and evidence suggests that it increases the risk of oral cancer, gingivitis, and tooth loss. The risk of cancer in people who use smokeless tobacco is lower than that of smokers, but it is still higher than that of people who do not use tobacco at all. Using smokeless tobacco also seems to increase the risk of fatal heart attacks and strokes.

Pipes and Cigars

Pipe and cigar smoking are on the rise. Because pipe and cigar smokers often don't inhale, the common misperception is that they don't face as substantial a health risk as cigarette smokers. Yet research finds that smoking pipes or cigars causes harmful health effects similar to those of cigarettes.

People who smoke pipes or cigars are at greater risk for lung damage and chronic obstructive pulmonary disease (COPD), even if they never smoked cigarettes.

One type of pipe -- the water pipe (also known as a "hookah") -- is gaining popularity among college students, in part because of the mistaken belief that it is less harmful than regular cigarettes. Yet studies have found that smoking a water pipe carries the same risks as smoking cigarettes, including lung cancer, other lung disorders, and gum disease.



Health Risks:






Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence





Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence






Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence





Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence







Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence





Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence



Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence


Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence

Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of which are discussed below.

Effects on the Lungs

According to the American Lung Association, smoking is directly responsible for about 90% of the deaths due to lung cancer. The good news is that as smoking rates have declined, lung cancer rates have dropped too. In men, there were about 3% fewer cases of lung cancer in 2008 than in 2005. The risk in women fell by a little over 2% during the same time period.

Smoking is also responsible for most deaths due to COPD, which includes emphysema and chronic bronchitis. And smoking makes it harder to control asthma, by interfering with the response to steroid medicine and worsening lung function.

Cardiovascular Effects

Smoking, chewing tobacco, and being exposed to secondhand smoke all greatly increase the risk for heart attacks and strokes. The risk for heart problems in people who smoke or who are exposed to smoke may be three times greater than that of people who don't smoke. When people stop smoking, their risk of having a heart attack decreases over time.

Smoking also significantly increases the risk for peripheral artery disease, which damages the blood vessels in the legs and can lead to disability and amputation.

Effects on Male Fertility and Erectile Dysfunction

Smoking can harm a man's sexuality and fertility. Heavy smoking contributes to erectile dysfunction by decreasing the amount of blood flowing into the penis.

Smoking impairs sperm motility, reduces sperm lifespan, and may cause genetic changes that can affect a man's offspring. Men who smoke have less success with fertility treatments. They also have a lower sex drive and less frequent sex.

Effects on Female Infertility, Pregnancy, and Childbirth

Studies have linked cigarette smoking to infertility in women, and to health problems in their babies.

Negative effects of smoking include:

  • Greater risk for infertility. Women who smoke one or more packs a day and who started smoking before age 18 are at greatest risk for fertility problems.
  • Earlier menopause. Women who smoke tend to start menopause at an earlier age than non-smokers, perhaps because toxins in cigarette smoke damage eggs.
  • Pregnancy complications, which increase with the number of cigarettes smoked.
 Click the icon to see an image of an ectopic pregnancy.   Click the icon to see an image of an ectopic pregnancy. 

Pregnancy complications that are more common in smokers include:

  • Miscarriage
  • Stillbirth
  • Premature rupture of membranes
  • Premature delivery
  • Problems with the placenta

Smoking further increases the risk to the mother and unborn child in high-risk pregnancies.

Effects on the Unborn Child. Smoking during pregnancy increases the risk for:

  • Low birth weight
  • Birth defects (women who smoke during pregnancy have lower levels of folate, a B vitamin that is important for preventing birth defects)
  • Obesity and diabetes
  • Cleft lip (a split lip that has not closed during the fetus' development)

Some women have genes that may make them especially likely to deliver low-birth-weight infants if they smoke, although newborns of all female smokers are at greater risk for low birth weight. The good news is that women who stop smoking before becoming pregnant or during their first trimester of pregnancy reduce their risk of having a low-birth-weight baby compared to that of women who never smoked.

Women who want to become pregnant should make every attempt to stop smoking, and they should use smoking cessation aids before they try to conceive. Government guidelines recommend that doctors ask all of their pregnant patients about their tobacco use, and offer counseling to those patients who do smoke. After birth, if new mothers cannot quit, they should at least be sure not to smoke in the same room as their infant.

Pregnant women also need to avoid being around people who are smoking. Women who are exposed to secondhand smoke during pregnancy are 23% more likely to have a stillborn baby and 14% more likely to have a baby with a birth defect than women who are not exposed to secondhand smoke.

Effects on Bones and Joints

Smoking has many harmful effects on bones and joints:

  • Smoking can slow the process that adds calcium to bones and makes them stronger. Women who smoke are at high risk for bone density loss and osteoporosis.
 Click the icon to see an image of osteoporosis.   Click the icon to see an image of osteoporosis. 
  • Postmenopausal women who smoke have a significantly greater risk for hip fracture than those who do not smoke.
  • Smokers are more likely to develop degenerative disorders and injuries in the spine.
  • Smokers have more trouble recovering from surgery.
 Click the icon to see an image of rheumatoid arthritis.   Click the icon to see an image of rheumatoid arthritis. 

Smoking and Diabetes

Smoking may increase the risk of developing diabetes or glucose intolerance, a condition that precedes diabetes.

Smoking and the Gastrointestinal Tract

Smoking increases acid production in the stomach. It also reduces blood flow and the production of compounds that protect the stomach lining. This combination of effects increases the risk for certain gastrointestinal conditions.

Inflammatory Bowel Disease. Smoking has mixed effects on inflammatory bowel disease, the collective term for ulcerative colitis and Crohn's disease. Smokers have lower-than-average rates of ulcerative colitis, but higher-than-average rates of Crohn's disease. Smokers with Crohn's disease who quit smoking have less severe symptoms than those who continue to smoke.

 Click the icon to see an image of inflammatory bowel disease.   Click the icon to see an image of inflammatory bowel disease. 

Colorectal cancer. Smoking increases the risk of colorectal cancer and aggressive colon polyps, which are considered precursors to colon cancer. Cigarette smoking is also a known risk factor for pancreatic and gastric cancers.

 Click the icon to see an image of peptic ulcers.   Click the icon to see an image of peptic ulcers. 

Hepatitis and Cirrhosis. Smoking is linked to increased liver scarring (cirrhosis) from excessive drinking or chronic hepatitis B or C viruses.

Smoking and Other Types of Cancer

Bladder Cancer. Smoking is the single biggest risk factor for bladder cancer, which is diagnosed in about 70,000 Americans each year. The risk of bladder cancer among smokers may be even higher than was once thought. Current smokers are four times as likely to get the disease than non-smokers, and former smokers face double the risk of bladder cancer. Both female and male smokers face similar odds of getting bladder cancer.

Prostate Cancer. Men who smoke at the time of their diagnosis with prostate cancer fare much worse than non-smokers. Smokers are 61% more likely to see their prostate cancer return, and twice as likely to die from their cancer than men who never smoked. Men who quit smoking at least 10 years before their diagnosis are at the same risk as those who never smoked.

Smoking and Thyroid Disease

Cyanide, a chemical found in tobacco smoke, interferes with thyroid hormone production. Smoking triples the risk for developing thyroid disease, particularly hyperthyroidism (overactive thyroid) and hypothyroidism (underactive thyroid). Smoking has also been linked to goiter, a swelling of the thyroid that occurs in people who do not get enough iodine.

 Click the icon to see an image of the thyroid.   Click the icon to see an image of the thyroid. 

Smoking and Surgical Recovery

Smokers are at increased risk for heart and circulatory problems and delayed wound healing after surgery. Quitting smoking significantly lowers the risk of these complications. The longer patients are off cigarettes before their surgery, they better they will do after the procedure.

Smoking and Age-Related Disorders

The following age-related conditions are thought to occur at higher rates in smokers than non-smokers:

  • Cataracts. Quitting smoking reduces your chances of needing cataract surgery in the future, although you will still face a greater risk for this surgery than non-smokers.
 Click the icon to see an image of a cataract.   Click the icon to see an image of a cataract. 
  • Age-related macular degeneration (AMD). AMD is a leading cause of blindness in older people. Smoking is the second biggest risk factor for AMD, after age. Heavy smoking over a long period of time can significantly increase AMD risk.
  • Alzheimer's disease and dementia. Heavy smoking during middle age increases the risk for Alzheimer's disease and dementia by 100% in later life.
  • Gum disease and tooth loss. One-half or more of the cases of severe gum disease in American adults may be due to cigarette smoking.
  • Wrinkles. Smokers are nearly five times more likely to develop more and deeper wrinkles as they age compared to nonsmokers.
  • Baldness and premature gray hair. Certain chemicals in smoke break down in hair cells, which leads to hair damage.
  • Hearing loss, particularly high-frequency hearing loss
  • Incontinence




Smoking -- even just a few cigarettes a day -- has been linked to many serious health risks. Up to half of all current tobacco users will die from a tobacco-related disease, many of w