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Dr Ian Walker on Smoking: ‘The killer behind the counter’

Ian Walker
by Ian Walker | Opinion

17 March 2023

1 comment 1 comment

a smoking cigarette
This entry is part 1 of 3 in the series Ian Walker on smoking

The link between smoking and cancer was first established over 60 years ago. Some of those early studies have been further validated across years of research. 

We now know that cigarette smoke contains over 5000 different chemicals, of which we know at least 70 are carcinogenic. This toxic cocktail of chemicals has huge impact on the health of people exposed to tobacco smoke.  

Smoking is linked to at least 15 different cancers, as well as many other medical problems, including heart disease, respiratory disorders and fertility issues.  

But what is so different about cigarettes?   

There are many things we that we know are risk factors for cancer – such as obesity, UV radiation and alcohol.

Why are cigarettes any more dangerous?  

Well, cigarettes are a uniquely toxic cause of cancer. They are a targeted consumer item that, if used exactly as intended by the manufacturer, will ultimately kill two thirds of people who use them if they don’t stop smoking. Yes, really.  

In fact, smoking causes an estimated 125,000 deaths each year in the UK – around a fifth of all deaths from all causes.  

The science behind this is clear and indisputable. World-leading researchers from across the globe have spent decades identifying the different ways that smoking tobacco can cause cancer.  

One such example, is the chemical called Benzo[a]pyrene (BP), which is created when tobacco is burned and then inhaled into the lungs. This compound causes damage to the DNA within cells and generates mutations which can lead to many different types of cancer.  

In addition to these direct DNA mutations, many carcinogenic chemicals in tobacco cause DNA to behave abnormally. This can disrupt the usual replication of a cell, which again can lead to the development of cancer.  

A graph showing the decline in smoking rates between the 1950s and 2020 due to key policy changes

So, we know that tobacco is chemically dangerous for our physical health. But its danger also lies in the way it is sold as a consumer product. The business model is based on addiction. This addiction is caused by nicotine, a chemical in tobacco, which is easily absorbed via the lungs and into the blood. 

After it’s in the blood, it is distributed around the body and causes the release of dopamine in the brain. This is the body’s “reward’ mechanism, and our brains are wired to want more. Very soon, we have the desire for another reward and then another, until we can’t function normally without it.  

Nicotine is very addictive, but despite this, you can simply nip to your local corner shop to buy a 20 pack. 

We know that most who smoke become addicted to cigarettes when they are younger. In fact, nearly all those who smoke, start smoking before the age of 21, become addicted and then spend many years trying and failing to stop.  

The problems that smoking will cause for people can seem so distant, and once a physical addiction has taken hold, these reasons alone are often not enough to stop.  

In fact, we know that most people who smoke want to quit, but they need support to do it successfully. This is on top of social inequalities and barriers beyond people’s control which can impact someone’s likelihood to start smoking, and their ability to stop.  

But the sad truth is that for most people who smoke, the effects of their addiction will eventually catch up with them.  

Indeed, my grandfather fits this story exactly. He became addicted to smoking as a child in Ukraine, before emigrating to the UK after the Second World War.  

He smoked almost all his life and paid the ultimate price because of the addiction he developed as a child, when he died from cancer. This impact was felt widely across my family and represents just one of the estimated 9 million deaths caused by smoking since the 1960s in the UK.  

This may seem like a hopeless cycle, but we have the research to prove that there is a way out of it.  

Black and white headshot of Ian WalkerBrave political leadership today, could prevent tens of thousands of cancer deaths from tobacco each year, and help to remove this terrible burden from the next generation. We could realistically see the day when none of our children become addicted to smoking – a legacy that any Government could be proud of. I’ll be explaining just how vital this action is in next week’s article.  

Ian Walker is executive director of policy, information and communications at Cancer Research UK


    Comments

  • Luella A Santiago-Dawson
    22 March 2023

    I am a smoker and I love to smoke. But hate that I do smoke. It’s a tug of war with our addiction, that keeps us from quitting. I want to quit but I’m afraid to quit. It makes no real sense really. I think it would be great if the government would stop the manufacturing of cigarettes, period. Also the growth of tobacco! That would be great, and healthy to millions of smokers a d non-smokers alike. And I feel that’s what it would take to make the vicious circle of death from cigarette smoke to stop!!! I know I need to quit or I’m going to die a horrible death from smoking. And like most smokers we just keep sucking on those cancer sticks. HELPPP!!! I WANT TO QUIT SMOKING!!

  • reply
    Jacob Smith
    31 March 2023

    Hi Luella,

    Thanks for your comment.

    Most people who smoke want to quit and regret ever starting. But smoking is an addiction and stopping can be really hard, which is why people need more support to stop. We also know that some people are more likely to try a cigarette than others, and often factors outside of our control can make all the difference.

    That’s why governments across the UK have a huge responsibility to protect people who are at higher risk of tobacco-related harm. We believe that a key priority is ensuring people have access to the right tools and support to help them quit. That’s why our Smokefree UK campaign focuses on making sure there is funding available for stop smoking services and public health campaigns so everyone has support to stop smoking.

    We also want to prevent young people from ever starting to smoke. Raising the age of sale of tobacco – either to 21 or by a year each year (such as in New Zealand) could help prevent people from starting smoking. That’s why we’re calling for a consultation on raising the age of sale and the best way to do so.

    It’s not easy, but more and more people are in the UK are successfully stopping smoking. It’s never too late to quit. There are lots of options available to help you stop smoking. Treatment and support at your local free stop smoking service give you the best chance of success. Find out more about how to stop smoking on our website.

    I hope that helps,
    Jacob

    Comments

  • Luella A Santiago-Dawson
    22 March 2023

    I am a smoker and I love to smoke. But hate that I do smoke. It’s a tug of war with our addiction, that keeps us from quitting. I want to quit but I’m afraid to quit. It makes no real sense really. I think it would be great if the government would stop the manufacturing of cigarettes, period. Also the growth of tobacco! That would be great, and healthy to millions of smokers a d non-smokers alike. And I feel that’s what it would take to make the vicious circle of death from cigarette smoke to stop!!! I know I need to quit or I’m going to die a horrible death from smoking. And like most smokers we just keep sucking on those cancer sticks. HELPPP!!! I WANT TO QUIT SMOKING!!

  • reply
    Jacob Smith
    31 March 2023

    Hi Luella,

    Thanks for your comment.

    Most people who smoke want to quit and regret ever starting. But smoking is an addiction and stopping can be really hard, which is why people need more support to stop. We also know that some people are more likely to try a cigarette than others, and often factors outside of our control can make all the difference.

    That’s why governments across the UK have a huge responsibility to protect people who are at higher risk of tobacco-related harm. We believe that a key priority is ensuring people have access to the right tools and support to help them quit. That’s why our Smokefree UK campaign focuses on making sure there is funding available for stop smoking services and public health campaigns so everyone has support to stop smoking.

    We also want to prevent young people from ever starting to smoke. Raising the age of sale of tobacco – either to 21 or by a year each year (such as in New Zealand) could help prevent people from starting smoking. That’s why we’re calling for a consultation on raising the age of sale and the best way to do so.

    It’s not easy, but more and more people are in the UK are successfully stopping smoking. It’s never too late to quit. There are lots of options available to help you stop smoking. Treatment and support at your local free stop smoking service give you the best chance of success. Find out more about how to stop smoking on our website.

    I hope that helps,
    Jacob