Cleveland Clinic pulmonologist, Humberto Choi M.D.

Enjoying an occasional cigarette, shisha, or cigar is much more harmful than many ‘social smokers’ realize, with physicians warning that you don’t have to smoke every day to seriously damage your health.

Humberto Choi, a pulmonologist with Cleveland Clinic in the United States, and a leading specialist in several smoking-related lung diseases, says there is no safe level of smoking – a point that research is making very clear.

“What these studies are showing is that even when someone does not smoke very frequently, they are still at an increased risk of death when compared to people who have never smoked in their lives,” he says.

One of the most comprehensive studies looked at data on 70,913 adults in the United States, pooling data from health surveys dating back to the early 1990s, and then checking people’s health outcomes over time.

Researchers found that when compared to people who had never smoked a cigarette, those who were lifelong non-daily smokers had a 72 percent increased risk of death. Non-daily smokers reported smoking cigarettes for an average of 15 days per month, roughly 50 cigarettes per month, as opposed to about 600 a month for daily smokers.

While the existing research concentrates on cigarettes, Dr. Choi says it highlights risks associated with other forms of smoking, such as shisha or cigars, which are often seen as an occasional indulgence, and which are particularly popular in the Middle East.

“The long-term consequences from water-pipe smoking is not really clear, just because the way that people smoke them is very different, but there are many immediate complications that we can clearly identify,” explains Dr. Choi.

“Anything that is inhaled, even in a vapor form, into the lungs can cause immediate inflammation, including some inflammation that may look like pneumonia on a CT scan. Inhaling from a water pipe can also cause bronchospasm – a reaction from the airways.”

Dr. Choi says that vaping devices and e-cigarettes are also problematic, with physicians seeing greater and more harms from the practice. He is particularly concerned by younger non-smokers, including teens, taking up vaping – people he believes would not otherwise become smokers.

“I think one of the major consequences is addiction itself. We will see, unfortunately, in several years, what the long-term effects of vaping will be,” he added.