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Effects of active tobacco smoking on health

  • Page | Last updated: 08 Sep 2026
Health Promotion and Disease Prevention

Effects of active tobacco smoking on health

Active smoking is the deliberate act of inhaling and exhaling smoke from burning substances or agents.
 

General/multiple health outcomes

  • 'Smoking is habit-forming and physically addictive, and causes premature illness and death due to lung cancer, COPD, cardiovascular disease and a host of other ailments, as well as reducing lung function and complicating other diseases such as asthma and tuberculosis.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and diminished health status that may manifest as increased absenteeism from work and increased use of medical care services.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and diminished overall health. Manifestations of diminished overall health among smokers include self-reported poor health, increased absenteeism from work, and increased health care utilization and cost.'
  • 'The evidence is sufficient to infer that cigarette smoking increases risk for all-cause mortality in men and women.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and increased risks of adverse surgical outcomes related to wound healing and respiratory complications'.
  • 'Cigarette smoking has been causally linked to diseases of nearly all organs of the body, to diminished health status, and to harm to the fetus.'
  • 'In addition to causing multiple diseases, cigarette smoking has many other adverse effects on the body, such as causing inflammation and impairing immune function.'
  • Short-term health effects of tobacco and nicotine use are increased blood pressure, breathing, and heart rate.
  • Long-term health effects of tobacco and nicotine use are greatly increased risk of cancer, especially lung cancer when smoked and oral cancers when chewed; chronic bronchitis; emphysema; heart disease; leukemia; cataracts; pneumonia.

Cardiovascular disease

 

ERS 2013
  • 'Smoking […] causes premature illness and death due to […] cardiovascular disease […].'
WHO 2020 (pdf)
  • Tobacco use, including exposure to second-hand smoke, harms the cardiovascular system.
HHS 2004 (pdf), HHS 2014 (pdf)
  • 'The evidence is sufficient to infer a causal relationship between smoking and coronary heart disease.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and stroke.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and abdominal aortic aneurysm, between active smoking in adolescence and young adulthood and early abdominal aortic atherosclerosis in young adults, and between smoking and subclinical atherosclerosis.'

Cancer

Cancer

ERS 2013
  • 'Smoking […] causes premature illness and death due to lung cancer […].'.
  • 'There is sufficient evidence in humans for the carcinogenicity of tobacco smoking.'
  • 'Tobacco smoking causes cancers of the lung, oral cavity, naso-, oro- and hypopharynx, nasal cavity and accesory sinuses, larynx, oesophagus, stomach, pancreas, colorectum, liver, kidney (body and pelvis), ureter, urinary bladder, uterine cervix and ovary (mucinous), and myeloid leukaemia. Also, a positive association has been observed between tobacco smoking and cancer of the female breast.'.
  • 'Tobacco smoking and tobacco smoke are carcinogenic to humans (Group 1).'
  • 'Tobacco is a primary cause of cancer in the mouth (oral cancer).'
  • 'The evidence is sufficient to infer a causal relationship between smoking and bladder cancer, cervical cancer, colorectal adenomatous polyps and colorectal cancer, cancers of the esophagus, renal cell and renal pelvis cancers, cancer of the larynx, acute myeloid leukemia, hepatocellular carcinoma, lung cancer, cancers of the oral cavity and pharynx, pancreatic cancer, and gastric cancers.'
  • 'The evidence reviewed shows that the risk of lung cancer associated with smoking has increased over time. The evidence is sufficient to identify mechanisms by which cigarette smoking may cause breast cancer.'

Respiratory health

  • 'Smoking […] causes premature illness and death due to […] COPD, […] as well as reducing lung function and complicating other diseases such as asthma […].'
  • 'The evidence is sufficient to infer that smoking is the dominant cause of chronic obstructive pulmonary disease (COPD) […]. Smoking causes all elements of the COPD phenotype, including emphysema and damage to the airways of the lung.'
  • 'The evidence is sufficient to conclude that there is a causal relationship between active smoking and wheezing severe enough to be diagnosed as asthma in susceptible child and adolescent populations, and between active smoking and exacerbation of asthma in adults.'
  • 'The evidence is sufficient to infer a causal relationship between active smoking and all major respiratory symptoms among adults, including coughing, phlegm, wheezing, and dyspnea, and between smoking and acute respiratory illnesses, including pneumonia, in persons without underlying smoking-related chronic obstructive lung disease.'
  • 'The evidence is sufficient to conclude that there is a causal relationship between active smoking and both reduced lung function and impaired lung growth during childhood and adolescence.'
  • 'The evidence is sufficient to infer a causal relationship between active smoking and the early onset of lung function decline during late adolescence and early adulthood; respiratory symptoms in children and adolescents, including coughing, phlegm, wheezing and dyspnea; and asthma-related symptoms (i.e. wheezing) in childhood and adolescence.'

Neuropsychiatric disorders

  • 'Smoking is habit-forming and physically addictive.'
  • 'Nicotine is addictive. Most smokers use tobacco regularly because they are addicted to nicotine. Addiction is characterized by compulsive drug-seeking and use, even in the face of negative health consequences.'
  • 'Nicotine withdrawal symptoms include irritability, attention and sleep problems, depression, increased appetite.'
  • 'Nicotine exposure in adolescents can affect the development of brain circuits that control attention and learning.'

Reproductive and sexual

HHS 2004 (pdf), HHS 2014 (pdf)
  • 'The evidence is sufficient to infer a causal relationship between smoking and reduced fertility in women.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and erectile dysfunction.'

Eye health

  • 'The evidence is sufficient to infer a causal relationship between smoking and nuclear cataract.'
  • 'The evidence is sufficient to infer a causal relationship between cigarette smoking and neovascular and atrophic forms of age-related macular degeneration.'

Skeletal and dental disease

  • 'Tobacco use is a major cause of periodontal disease and premature loss of teeth'.
  • Some of the most common oral diseases are linked to tobacco use and include leukoplakia (lesions which potentially lead to oral cancer), oral mucosal conditions, periodontal conditions, premature tooth loss, acute necrotising ulcerative gingivitis, staining and halitosis.
  • 'The evidence is sufficient to infer a causal relationship between smoking and hip fractures.'
  • 'In postmenopausal women, the evidence is sufficient to infer a causal relationship between smoking and low bone density.'
  • 'The evidence is sufficient to infer a causal relationship between smoking and periodontitis'.

Diabetes Mellitus

  • 'The evidence is sufficient to infer that cigarette smoking is a cause of diabetes.'.
  • 'There is a positive dose-response relationship between the number of cigarettes smoked and the risk of developing diabetes.'

Rheumatoid arthritis

  • 'The evidence is sufficient to infer a causal relationship between cigarette smoking and rheumatoid arthritis.'

Peptic ulcer

  • 'The evidence is sufficient to infer a causal relationship between smoking and peptic ulcer disease in persons who are Helicobacter pylori positive.'

Infectious disease

  • 'Smoking [complicates] other diseases such as […] tuberculosis.'
  • 'Passive or active exposure to tobacco smoke is significantly associated with tuberculous infection and tuberculosis disease. Active smoking is significantly associated with recurrent tuberculosis and tuberculosis mortality'.
  • 'The evidence is sufficient to infer a causal relationship between smoking and increased risk of Mycobacterium tuberculosis disease, and mortality due to tuberculosis'.
More information and links
Originally Published | Last Updated

12 Mar 2021 | 08 Sep 2026

Knowledge service | MetadataHealth Promotion and Disease Prevention | Risk factors of non-communicable diseases | Tobacco and smoking
Digital Europa Thesaurus (DET)health policy
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