Bad news for "social smokers" - just one drag on that cigarette could be the one that causes your heart attack.
Lung cancer is what people usually fear from smoking, and yes, that can take years to strike. But the surgeon general's 30th annual report on smoking and health says tobacco smoke begins poisoning immediately, as more than 7,000 chemicals in each puff rapidly spread through the body to cause damage to nearly every organ.
"Too often people think the occasional social cigarette is not so dangerous, when in fact this report says yes, it is," says Dr. Terry Pechacek of the Centers for Disease Control and Prevention.
Even inhaling secondhand smoke could be enough to block the arteries and trigger a heart attack, according to the report.
Why? Cigarette smoke immediately seeps into the bloodstream and changes its chemistry so that blood becomes more sticky, allowing clots to form that can squeeze shut already narrowed arteries, the report explains. That's in addition to the more subtle long-term damage to blood vessels themselves, making them more narrow. And no one knows how little it takes to trigger that clotting.
The report is not without good news. Surgeon General Regina Benjamin says kicking the habit lets the body start healing immediately. "It's never too late to quit," she says, "but the sooner you quit, the better. Even if you're 70, 80 years old and you're a smoker, there's still benefit from quitting."
But what about the millions who want to quit but are having a hard time? Benjamin says cigarettes are designed for addiction, and that smokes today deliver nicotine more quickly and efficiently than ever.
About 443,000 Americans die from tobacco-caused illnesses every year. While the smoking rate has dropped dramatically since 1964, when the first surgeon general's report declared tobacco deadly, progress has stalled in the past decade. About 46 million adults - one in five - still smoke, and tens of millions more are regularly exposed to secondhand smoke.
"How many reports more does Congress need to have to say that cigarettes as a class of products ought to be banned?" asked well-known nicotine expert Dr. K. Michael Cummings of the Roswell Park Cancer Institute, who helped to review the report. "One-third of the patients who are in our hospital are here today because of cigarettes."
Now that's a drag.