OK, what has gotten a lot of press from a truly extensive Surgeon General’s report on cigarettes released yesterday is a conclusion that “there is no safe level of cigarette smoke.”

The media has turned this into “just one cigarette can kill you.” Unfortunately, the report does contain a passage that just a few minutes of cigarette smoke can give a person with heart disease a heart attack. Well, having someone sneak up on you from behind and say, “Boo!” can give you a heart attack if you have serious heart disease. It’s a really stupid point.

The real crux of the report, which the media has missed somewhat, is that it examines how cigarettes cause various forms of cancer and lung disease.
In summary:
• The chemicals and toxicants in tobacco smoke damage DNA, which can lead to cancer. Nearly one-third of all cancer deaths every year are directly linked to smoking. Smoking causes about 85% of lung cancers in the U.S.
•Exposure to tobacco smoke quickly damages blood vessels throughout the body and makes blood more likely to clot. This damage can cause heart attacks, strokes, and even sudden death.
• The chemicals in tobacco smoke inflame the delicate lining of the lungs and can cause permanent damage that reduces the ability of the lungs to exchange air efficiently and leads to chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.

I found the lung cancer chapter the most interesting. Sure enough, here is the conclusion I was looking for:

“There is consistent evidence that a combination of polymorphisms in the CYP1A1 and GSTM1 genes leads to higher DNA adduct levels in smokers and higher relative risks for lung cancer than in those smokers without this genetic profile.
“Exposure to cigarette smoke carcinogens leads to DNA damage and subsequent mutations in TP53 and KRAS in lung cancer.”

So, here’s the thing to wrap your heads around. Smoking fucks with your DNA. It isn’t just irritating the cells of your lungs, it’s actually changing the DNA of those cells.

The various cancers mentioned by the report were lung, mouth, throat, stomach, pancreas, bladder, kidney and leukemia. Surprisingly, lymphoma was not mentioned. I had always thought there was an increased risk of lymphoma if you smoked, but this report doesn’t mention that, so I suppose not.

One of the things that has long baffled scientists is why most smokers don’t get lung cancer. Somewhere between 10 to 20 percent do, depending on what study you read. Why don’t the 80 or other 90 percent get lung cancer is smoking is carcinogenic?

The answer apparently is in genetics, which the report refers to above, and I was hoping it would talk about that. People with a certain gene are more prone to lung cancer. If they smoke and have this gene, they are at extreme risk of lung cancer. If they don’t smoke, they are still at elevated risk of lung cancer. That’s why 10 percent of men who get lung cancer aren’t smokers, and 20 percent of women. Perhaps there are other environmental factors, such as radon or air pollution. But, the fact remains, that roughly 85 percent of the people who get lung cancer are smokers.

So, if you don’t have this gene and smoke, you will probably never get lung cancer. You may die in your 50s of heart disease or die from COPD or some other form of cancer, but you probably won’t get lung cancer. So, you’re not somehow magically out of the woods if you don’t have this gene. It isn’t that simple.
Anyway, here is the press release on this report. You can download the whole 700-page document if you wish. Or you can just download the executive summary.