Dear Nurse Felicia,

I am not a regular smoker but sometimes I do smoke especially when I am out with friends and drinking. I enjoy smoking a cigarette or two. I never smoke during the day or on weekdays and never buy my own packs. Is this occasional social smoking really all that harmful to my health?
Just One

Dear Just One,

Normally, I am a big proponent of moderation but in this case, the simple answer is yes, and even just a few cigarettes a day can be very hazardous to your health. While lung cancer risk may be cumulative relative to the number of cigarettes one smokes, studies have shown that people who smoke less than a pack a week have just as much blood vessel damage as those who smoke a pack a day or more.

This damage leads to atherosclerosis, allowing fat and cholesterol to build up on arterial walls, and potentially resulting in heart attack or stroke. 

More importantly, very few social smokers are able to remain so over time. In fact, one study demonstrated that roughly half of all subjects who reported smoking only "socially” or "casually” at the beginning of the study were smoking daily after one year.

Other studies have shown that cigarettes may actually be more addictive than heroin or cocaine, so while you may start off with one or two here and there you will likely find that the number starts to creep up.

So perhaps you might want to evaluate your drinking as well. On the flip side, if you are going out drinking as an excuse to smoke then you may also be inadvertently increasing your alcohol consumption, exposing yourself to additional health risks.

The bottom line is to quit while you’re ahead. Tapering off rarely works, since most social smokers already know, so you’ll have to make a decision to just quit, period.

Products such as nicotine gum, lozenges, or skin patches can help and it may take trying a couple of different options to discover which one is right for you. For more information on quitting, talk to your health care provider or visit

Felicia Price is an American Registered Professional Nurse working in Kigali.

Please send your health queries – whatever they may be - to askfelicia@gmail.com