Effects of smoking

Expert review by:
  • Angana Nankani, Bupa Clinics GP

Smoking is the most common cause of preventable disease in the UK. It can cause heart disease, cancer, lung diseases and more. Nearly 78,000 people die each year in the UK from smoking-related causes. Many more live in poor health because of smoking.

Here we discuss the harm that smoking does to your body. But you can improve your health by giving up, so we’ve also got advice on how to quit.

Smoking and life expectancy

On average, smoking reduces your life expectancy by 10 years. After you reach 40, each additional year you smoke reduces your life expectancy by another three months.

Although smoking increases your risk of many serious illnesses, most of the deaths caused by smoking are due to three main conditions. These are lung cancer, chronic obstructive pulmonary disease (COPD) and cardiovascular (heart and circulation) disease.

Smoking and cancer

Cigarette smoke contains more than 5,000 chemical compounds and over 60 of these are known to cause cancer. Smoking is by far the greatest avoidable risk for developing many types of cancer. Hand-rolled cigarettes are just as harmful as ready-made cigarettes.

If you smoke, you increase your risk of getting at least 16 different types of cancer, including:

Smoking is also linked to some types of leukaemia (cancer of the white blood cells).

Smoking and your heart and circulation

Smoking can cause serious problems with your heart and blood circulation. It damages your blood vessels, raises your blood pressure and heart rate and makes your blood more likely to clot. If you smoke, you increase your risk of getting heart disease and having a heart attack. You’re also more likely to have a stroke and develop peripheral arterial disease (where the arteries to your legs become narrowed, so blood flow is restricted)

There is no safe level of smoking. Even one cigarette a day greatly increases your risk of heart or circulation problems. Here are some examples of the risks.

  • If you smoke 20 or more cigarettes a day, your risk of having a stroke can be up to six times that of a non-smoker. The more you smoke, the more likely you are to have a stroke.
  • If you’re under 50 and smoke, you may be five times more likely to have a heart attack than a non-smoker.

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Smoking and your lungs and breathing

If you’re regularly breathing in smoke, your airways and lungs will get damaged. The smoke irritates and inflames your airways. It can become harder for you to get air in to and out of your lungs and you can develop chronic obstructive pulmonary disease (COPD). Most people who get COPD are long-term smokers.

The damage to your airways from smoking makes you more at risk of getting an infection like pneumonia. And if you have asthma, smoking may make your symptoms more severe, or last longer.

If you smoke, you may feel that your breathing is OK, but your lungs may be damaged even before you have any symptoms.

Smoking and your appearance

As well as being harmful, smoking can affect your appearance. Many smokers say that the effect on their appearance was one of the things that made them decide to quit smoking.

Smoking, wrinkles, and ageing

Smoking affects the structure of your skin, making you more likely to get wrinkles. Smokers in their 40s may have as many wrinkles as non-smokers in their 60s. These may be especially noticeable around your eyes and mouth.

Other effects of smoking on your appearance

These include:

  • being more likely to get acne, with slower healing of skin blemishes or wounds
  • bad breath and stained teeth and gums
  • damage to your gums leading to loss of teeth
  • irritation of your eyes making them appear bloodshot
  • staining of your fingers, so they become discoloured and yellow

Smoking and your fertility

Smoking can cause infertility in both men and women. Breathing in second-hand smoke from smokers around you is also likely to affect your chance of conceiving.

Men who smoke are more likely to have damaged sperm, which are less able to fertilise an egg. Men are also at a greater risk of erectile dysfunction if they smoke.

Women who smoke take longer to get pregnant than non-smokers. And they may go through the menopause earlier than women who don’t smoke.

Smoking can also affect the success of fertility treatment such as in vitro fertilisation (IVF).

Smoking and your recovery from operations

Smoking increases the risks associated with general anaesthesia, as well as the risks specific to the operation you have. If you smoke, you may be up to six times more likely to get breathing problems during an operation.

If you smoke, your body will take longer to heal after an operation. Your surgical wounds won’t heal as quickly. Your risk of getting complications is higher too. This means you may need a longer recovery period, with more time in hospital and off work.

This is why you’ll be strongly advised to give up smoking before you have any planned surgical procedure. You may need to give up at least six weeks before your operation to get the most benefit.

Why smoking is bad for people around you

When you smoke, anyone near you will be breathing in the smoke you exhale, and the smoke from the end of your cigarette. This is called second-hand smoking or passive smoking and is harmful for others. Second-hand smoking can cause the same range of illnesses that affect those who smoke themselves.

Short-term effects of second-hand smoke

Being exposed to second-hand smoke is very unpleasant. Not only does the smell linger on your clothes and hair, but it can also give you a headache, cough or sore throat. It can also irritate your eyes and make you feel sick or dizzy. If you have asthma, being in a smoky place may make your symptoms worse.

Long-term effects of second-hand smoke

If you're regularly exposed to second-hand smoke, your risk of developing smoking-related diseases such as heart disease and lung cancer increases. You may also be more likely to develop conditions that affect your breathing, such as chronic obstructive pulmonary disease (COPD).

Second-hand smoking in pregnancy

If you’re exposed to second-hand smoke while you’re pregnant, your baby may not develop properly and may have a low birth weight. This could potentially put your baby at risk. There is also a higher risk of your baby being born early or being stillborn. For more information, see our section: Why smoking is harmful if you’re pregnant.

Second-hand smoking and children

Second-hand smoke is particularly harmful for babies and children. If young children are exposed to second-hand smoke, they’re more likely to get:

  • chest infections like bronchitis and pneumonia
  • glue ear or a middle ear infection
  • asthma – with more severe attacks in smoky places
  • meningitis
  • cot death (sudden infant death syndrome, SIDS)

Children who grow up with parents or siblings who smoke are also more likely to become smokers themselves.

Why smoking is harmful if you're pregnant

Smoking during pregnancy can cause problems with the pregnancy and harm your baby. Smoking reduces the amount of oxygen your baby gets and causes harmful chemicals to pass through the placenta to them. If you smoke while you’re pregnant, there is an increased risk of:

  • miscarriage
  • ectopic pregnancy
  • placental abruption – when the placenta comes away from the wall of your womb, which can be fatal to your baby
  • having a stillborn baby
  • your baby being born too early (prematurely)
  • your baby having a low birth weight, which may lead to more health problems
  • abnormalities of your baby’s development palate

Problems after your baby is born

The risk of cot death or sudden infant death syndrome (SIDS) is higher if you or your partner smokes, particularly if you share a bed with your baby at night. And they may be more likely to get health problems in later life including serious respiratory conditions like asthma. Smoking while you're pregnant may also affect how well your child goes on to do at school.

The more you smoke, the greater the risk of problems for your baby. There’s no safe level of smoking, so your medical team will encourage you and your partner to give up smoking completely if possible.

How to stop smoking

If you’ve decided you want to stop smoking, it’s probably the best thing you can do to improve your own health, and the health of those around you. Stopping smoking isn’t easy, but you’re not alone and there are plenty of resources available to help.

A good way to stop smoking is to contact the free, NHS Stop Smoking Service. You’ll have a one-to-one appointment with an expert advisor, and there may be group support and drop-in sessions in many areas. You can contact the service directly. Your pharmacist can also give you advice about ways to stop smoking.

There are medicines which can help you to stop smoking. These include nicotine replacement therapy (NRT) or varenicline (Champix®) or bupropion (Zyban®). You usually get these through the Stop Smoking Service or your GP. Always carefully read the information that comes with your medicine and if you have any queries, ask your pharmacist.

You may choose to use e-cigarettes (‘vaping’) to help you quit smoking. Neither the Stop Smoking Service, nor your GP can prescribe e-cigarettes for you. But they can talk to you about the risks and benefits of using them and support you in your efforts to stop smoking.

It can be a huge challenge to give up smoking, but with the right treatment and support you’re much more likely to do it. Your best chance of success is with a combination of medicines and psychological support.

If you have a lapse, don't give up – try again. And again, if necessary. Stopping smoking involves changing your lifestyle and habits and getting rid of an addiction you may have had for years. Most smokers have several attempts to give up before they finally succeed.

The benefits of stopping smoking

The good news is that it’s never too late to stop smoking and, when you do, the benefits to your health start immediately.

When you stop smoking:

  • within just 20 minutes, your pulse and blood pressure reduce
  • within eight hours, your oxygen levels return to normal and the amount of carbon monoxide in your blood will be reduced by half
  • within two days, your sense of taste improves
  • within one month, your complexion may improve and wrinkles reduce
  • within three to nine months, your lung function can improve
  • after one year, your extra risk of heart attack is half what it was when you smoked
  • after 10 years, your risk of lung cancer will be half that of someone who smokes
  • after 15 years, your risk of a heart attack is the same as somebody who has never smoked

And as well as all these health benefits, quitting smoking is good for your finances. You might even be able to treat yourself to a holiday with the money you save.

Soon after smoking your heart rate and blood pressure increase. Over time smoking can raise your risk of many health conditions, negatively affect your appearance and cause infertility.

Using the NHS Stop Smoking Service is a good place to start. They will provide you with expert advice, and medication if necessary. Having a good support network can help you to succeed in smoking. And don’t give up if you relapse – this is a normal part of stopping smoking for many.

See our section on how to stop smoking for more information.

Smoking may worsen anxiety and depression. One of the reasons for this is that nicotine temporarily relaxes you, but then causes withdrawal type symptoms in between cigarettes. Finding other coping mechanisms for stress can help – such as yoga or meditation.

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