Health Effects of Smoking

Source: The health consequences of smoking. A report by the US Surgeon General, 2014

The cold hard facts

  • Smoking causes more disease and illness in Australia than any other single preventable cause
  • 19,000 Australians die each year from smoking
  • Smokers lose 10-12 years of life on average
  • Up to 2 in 3 long-term smokers is killed by smoking
  • 12% of all deaths in Australia are due to smoking
  • One in 5 cancers is due to smoking
  • The smoker loses an average of 3 months of life for each year quitting smoking is delayed after age 35

Causes of death

The main causes of death in Australia from smoking are

  1. Lung cancer
  2. COPD – chronic bronchitis or emphysema
  3. Heart attack
  4. Stroke
  5. Oesophageal cancer


Lung cancer

Lung cancer is the leading cause of death from cancer in Australia in both men and women. Smoking causes 78% of lung cancer (84% in men, 71% in women).

Australian smokers have 17x the risk of lung cancer (24x for heavy smokers) compared to non-smokers. The risk increases with the number of years of smoking and the daily cigarette intake.

The average age of lung cancer is 71 years for men, 70 years for women. Only 12% of lung cancer sufferers survive 5 years.

Other cancers

Smoking is known to cause 13 other cancers:

  • Mouth and throat
  • Larynx (voicebox)
  • Oesophagus
  • Acute myeloid leukaemia
  • Stomach
  • Pancreas
  • Kidney
  • Cervix
  • Bladder
  • Liver
  • Colon
  • Ovary
  • Breast

Click here to download a detailed fact sheet about smoking and cancer.

Other diseases


About 1 in 4 smokers develop COPD (chronic obstructive pulmonary disease) which causes breathlessness, cough and sputum. Breathing gradually deteriorates over time, there are repeated chest infections, hospital admissions and eventually oxygen is required.

Heart attack

Smoking triples the risk of having a heart attack. Smoking increases blood clotting and narrows the arteries around the heart (atherosclerosis). The risk of a sudden death is increased by 2-3x that of a non-smoker. After a coronary stent or bypass, the risk of a further blockage is greatly increased.


Smokers are twice as likely to have a stroke as non-smokers. A stroke occurs when an artery to the brain becomes blocked or bleeds and part of the brain dies, resulting in paralysis, difficulty speaking, loss of mental functions or death. The risk of stroke increases the heavier and longer you smoke and especially if you are on the contraceptive pill.

Peripheral arterial disease (PAD)

The risk of blockage in the arteries is increased by about three times in smokers compared to non-smokers, especially in the legs and feet. This can lead to pain, gangrene and amputation. Smokers develop PAD 10 years earlier than non-smokers.

Aortic aneurysm

An aortic aneurysm is a weakening of the wall of the aorta, the main artery of the body. The wall can stretch and eventually burst and this is frequently fatal. Smoking increases he risk by 2-3x and quitting smoking approximately halves the risk of an aortic aneurysm.


Smoking increases the risk of developing asthma. People with asthma who smoke have worse asthma control, poorer response to treatment and accelerated decline in lung function.

Other respiratory disease

Smokers have higher rates of pneumonia, bronchitis, influenza, common cold, influenza and chicken pox, sleep apnoea and snoring.

Erectile Dysfunction

Smoking reduces the blood flow to the penis and is a major cause of erectile dysfunction (impotence). Even passive smoking increases the risk. Smoking also reduces the sperm count.


Smoking causes peptic ulcer (duodenal and gastric), gastro-oesophageal reflux and a 76% increased risk of Crohn’s disease. 

Mouth disease

Smoking causes cancer of the mouth, gingivitis (gum inflammation), periodontitis (inflamed gums and deeper tissues) and tooth staining.

Skin disease

Smoking causes increased wrinkling, and a pale, yellowish complexion. One study found that smokers appeared up to 4.7 years older than non-smokers. Smokers are also 80% more likely to develop psoriasis, a chronic disfiguring skin disease which affects about 3% of the population.

Eye disease

Smoking increases the risk of macular degeneration (the leading cause of blindness in Australia) by 2-3 times and the condition develops 10 years earlier in smokers. It also causes a 40% increased risk of cataracts (clouding of the lens) and is an important cause of thyroid eye disease (bulging eyes).

Obstructive sleep apnoea

Smoking doubles the risk of sleep apneoa

Other diseases

Smoking causes an increased risk of;

  • Complications of surgery: delayed wound healing, wound infections
  • Osteoporosis and bone fractures
  • Type 2 diabetes (35% increased risk)
  • Depression and suicide
  • Dementia
  • Rheumatoid arthritis and SLE (systemic lupus erythematosis)
  • Multiple sclerosis
  • Fire-related injuries

Women’s health

As well as the general effects of smoking, women are at increased risk of cancer of the cervix and ovary, infertility, dysmenorrhoea (painful periods) and premature menopause.

Smoking also increases the risk of breast cancer by 20-30%. However, more Australian women are now dying from lung cancer than breast cancer.


Smoking mothers and their babies are at substantial risk of serious health problems. The best time to quit is before you get pregnant so that your risk of complications is reduced to what it would be as a non-smoker.

Effects on the mother

Smoking approximately doubles the risk of

  • Ectopic (tubal) pregnancy
  • Spontaneous miscarriage
  • Placenta praevia and placental abruption (disorders of the placenta which can cause serious bleeding)
  • Preterm birth.

Effects on the child

  • Babies are 200g lighter at birth on average
  • The risk of of stillbirth (baby dead at birth) is doubled
  • There is a 2-3x greater risk of SIDS (sudden infant death syndrome)
  • Smoking affects the baby’s brain causing emotional, cognitive (thinking) and behavioural problems in childhood
  • Children have a higher risk of obesity, blood pressure, type 2 diabetes if their mother smoked in pregnancy
  • There is a significantly higher risk of certain birth defects, such as short limbs, clubfoot, eye defects, cleft lip
  • Children whose mothers smoke in pregnancy are also more likely to become smokers themselves later in life

Click here  to see an animated video which explains the risks further.

Second-hand smoking (passive smoking)

In adults

People who live with a smoker have a 30% increased risk of heart attack and a 20-30% increased risk of lung cancer. Passive smoking also causes and aggravates asthma, COPD, respiratory infections, eye/nose irritation and reproductive problems in women.

In children

Children are more susceptible to secondhand smoke than adults and are prone to middle ear infections, respiratory infections (croup, bronchitis, bronchiolitis, pneumonia) and SIDS (sudden infant death syndrome). Passive smoking can also cause and aggravate asthma in children.

Disorders less common among smokers

  • Ulcerative colitis
  • Parkinson’s disease
  • Pre-eclampsia (high blood pressure in pregnancy)
  • Some fetal developmental abnormalities (hypospadias and skin defects)


UK Royal College of Physicians, 2018
The Health Consequences of smoking. A report of the US Surgeon General, 2014

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