Ask your GP about smoking

Your GP will help you to give up smoking and can answer your questions about the various ways that it affects your health.

GP Dr Michael Apple answers some of your queries about quitting and the health risks of smoking.

I smoke fewer than five a day. What's the harm in that?
Almost a third of smokers smoke fewer than 10 a day and, like you, they often don’t see the point of giving up. But most of the heart disease risk comes within the first few cigarettes of the day.

Next time you light up, feel your pulse. It will start rising within a minute; that’s extra work for your heart whose own blood supply is reduced by nicotine. The tendency of your blood to clot increases with each cigarette, while the amount of oxygen it can carry goes down and is replaced by carbon monoxide. All of these are risk factors for heart disease. A study of 43,000 Norwegian smokers published in 2005 suggested that those who smoked up to five cigarettes a day were three times more likely to die of heart disease. Smoking just one cigarette a day trebles your risk of lung cancer and raises the risk of chronic lung disease, as well as cancer of the mouth, throat, bladder, pancreas and many more. It also makes it more difficult to conceive, lowers sperm count and causes more complications in pregnancy. Study after study shows that the risks increase the more you smoke, but all risks start with just one cigarette.

I get indigestion. Could it be because I smoke?
Yes. Smoking reduces the ability of the walls of the stomach to repair themselves and therefore increases the chances of acid indigestion and duodenal ulcer. If you stop smoking, food may become a lot more enjoyable! Not only will you be able to taste it better, but it’s less likely to give you indigestion. Some people find their irritable bowel syndrome (IBS) improves when they quit.

What is it about diabetes and heart disease that make smoking so dangerous?
In these conditions, the blood flow to your heart, legs, kidneys, eyes and brain is already affected, increasing the risks of strokes and heart attacks. Other risks are slow-healing ulcers and diseased legs and toes that might require amputation. When you smoke as well, you double or treble those risks.

Heavy smokers with diabetes have roughly double the chance of death from cardiovascular causes compared with non-smoking diabetics. People smoking up to 15 cigarettes a day have a 50% higher chance, while ex-smokers have a 10-30% increased chance, even 10 years after quitting.

I find it so hard to stop smoking. Am I weak?
No! Having trouble stopping smoking doesn’t make you weak, it makes you human: cigarettes are so addictive that 70% of smokers say they would like to quit, yet still smoke. Most ex-smokers make a few attempts before they stop for good.

It’s the nicotine in cigarettes that is physically addictive. It reaches the blood stream within a few drags, and alters various brain chemicals that change mood and concentration, which smokers find enjoyable. Stopping smoking can lead to intense feelings of anxiety, irritability and depression, feelings that smokers crave cigarettes to get rid of. Using nicotine replacement therapy (NRT) can help wean people off this physically addictive cycle.

While many people conquer their physical addiction for a few weeks or months, cigarettes are also psychologically and socially addictive. Being in a certain mood or place, or with certain people, can make ex-smokers light up again months or years later. Increasing social support while you quit by stopping with a partner or friend can help, as can joining an NHS stop-smoking group. Keeping a list of why you stopped in your purse or wallet, or a picture of your child or partner, or maybe a friend who died from smoking, can help you to avoid lighting up in years to come.