ABC News' Dr. Tim Answers Questions About Smoking

Nov. 8, 2005 — -- Question: I am a Internationally Board Certified Lactation Consultant, Health Educator, and RN. I currently practice in a local hospital's Family Birth Center helping families with breastfeeding challenges. Today I had a mom telephone me with a question regarding smoking cigarettes and breastfeeding her young baby. She wanted to know how long the chemicals from smoking remain in her breastmilk?
-- Frances Johnston-Hinds, Gresham, Oregon

Answer: The half-life of nicotine (the amount of time it takes for half the nicotine to be eliminated from the body) is ninety-five minutes. That does not mean that you can safely breastfeed 95 minutes after smoking. That means, even 95 minutes after smoking, half the amount of nicotine you got from smoking is still present in the body. Nicotine does pass into the breast milk and may reduce the volume of milk a mother can produce.

Maternal smoking has been linked to many infant health problems -- nausea, vomiting, abdominal cramps, diarrhea and increased risk of SIDS and respiratory problems. Smoking while breast-feeding has also been linked to fussiness. In one of many studies that follow the health of infants who were breast-fed by a smoker, 40 percent of babies breast-fed by smokers were rated as colicky (two to three hours of "excessive" crying) as compared with 26 percent of babies breast-fed by nonsmokers.
Source: Centers for Disease Control and Prevention

Question: I quit smoking 17 years ago until the summer of 2004. I smoked then for six months and quit. Since that time I have been chewing the Nicorette gum. I am concerned about the effects the gum/nicotine might have. I chew about six pieces of the 2-milligram gum per day. Is it a carcinogenic or can it lead to any heart disease or circulation problems?
-- Susan Hart, Grants Pass, Oregon

Answer: The major problem with nicotine is not its carcinogenic properties, which if they exist are weak, but its extremely addictive nature which "hooks" people on smoking and makes quitting extremely difficult. I would not be overly concerned about the modest levels present in the gum.
Consultation: UT Southwestern Medical Center at Dallas

Question: My paternal grandfather and my father both died from lung cancer. Both were heavy smokers. I am 55 and have never smoked, although I was exposed to secondhand smoke growing up. Does this history predispose me to develop lung cancer as well?
--Frank Scimeme, Brick, NJ

Answer: There is a relationship between genetics and development of certain cancers including lung cancer. Scientists have found the position of the lung cancer gene on the long arm of chromosome 6 and are close to identifying the culprit gene. Having two close relatives who developed lung cancer is suggestive but not definitive evidence of an inherited risk factor being present in the family, although not all members will have inherited the "bad" form of the gene. Finding the gene will permit at-risk individuals to be identified. Most of the people who are at-risk apparently still have to smoke in order to have a considerably increased risk of developing cancer. Thus a subject who is at risk but does not smoke, although there was modest exposure to secondhand smoke, will still be at relatively low increased risk.
Consultation: UT Southwestern Medical Center at Dallas

Question: What are the consequences of the occasional cigar or cigarette, occasional being maybe one or two a week? Are there cumulative consequences by only smoking on the few occasions?
-- Bob Banister, Portland, Oregon

Answer: Good question, and one that occasional (e.g., non-daily) smokers often ask. We know that smoking as little as one cigarette per day increases one's risk of heart attacks and cancer. Tobacco contains many harmful compounds and there is no scientific data to suggest that there is any safe level of tobacco use. A greater concern is that nicotine is a very addictive drug. An occasional smoker may, as time passes and during times of stress, start to smoke more and become a regular daily cigarette smoker. At that point, there is no question that smoking is harmful.

What I often ask people who smoke only occasionally is: "If you smoke so little, why smoke at all?"
Consultation: Massachusetts General Hospital

Question: Is there a significant difference between smoking cigarettes, cigars, or a pipe?
-- Dick Francis, Albuquerque, NM

Answer: Smoking any tobacco product has health risks. Most people who have always smoked cigars or pipes don't inhale the smoke as deeply into the lungs as cigarette smokers do -- largely because cigar and pipe tobacco is more irritating. As a result, their risk of lung cancer is less than that of smokers, but it is definitely much higher than nonsmokers. Furthermore, some smokers who switch to cigars transfer their habit of inhaling deeply, and if they do so, they are at the same risk.
Consultation: Massachusetts General Hospital