Question Title: Reversal of negative effects of smoking by teens

I had always heard that within a few years of quiting your risk for such things as lung disease, heart attacks and strokes goes down to nearly the same as a non-smoker. However on the news the other night a saw a very breif report that the damage cased by smoking as a teenager does not reverse and quiting smoking will still leave you with significant damage.

I'm tring to quit so I can have a longer and healthier life; however, this new information is quite disturbing. If you could give me anymore details on how much of the damage I've already done to myself and if this information on teen smoking is correct I woould appreciate it.

Dear Mike,

I have reproduced below the report of the finding you refer to from Reuters Health. Although I have yet to get my hands on the full journal article, my reading of this summary is that it simply suggests the possibility that some smokers who start as adolescents may sustain lung damage from smoking that is not as readily reversible following smoking cessation as many youthful smokers who took up smoking intending to "quit down the road" hoped it would be.

It would be wrong to read into this finding that "the damage is done, so I may as well keep on smoking." To the contrary, the more and longer a person smokes, the greater the cumulative health risk associated with smoking. This finding should serve as a wake up call to young people around the world - if you haven't started, don't start. If you smoke, quit now.

Now here's the Reuters Health summary of the findings:

Adolescent ex-smokers more susceptible to DNA damage than adult ex-smokers

WESTPORT, Apr 07 (Reuters Health) - Former smokers who started smoking during adolescence have higher levels of smoking-related DNA damage in lung tissue and blood than former smokers who started smoking as adults, US researchers report.

Dr. John K. Wiencke, of the University of California San Francisco, and colleagues there and elsewhere in the US measured the number of aromatic hydrophobic DNA adducts in nontumorous lung tissue of 143 patients who were under treatment for lung cancer and blood mononuclear cells from a subset of 54 of the patients.

In the April 7th issue of the Journal of the National Cancer Institute, they note that these adducts are thought to be associated with development of lung cancer.

Dr. Wiencke's group found that seven patients who had never smoked had, on average, 32 adducts per 10 billion nucleotides in lung tissue. The 57 patients in their study who were current smokers had on average 255 adducts per 10 billion nucleotides. Overall, former smokers averaged 113.

The study also included detailed histories from both smokers and former smokers on when they began smoking, how many cigarettes they smoked, and smoking duration.

The multicenter group discovered an inverse relationship between age at smoking initiation and the level of lung DNA adducts in former smokers. Those who began smoking before the age of 15 years had an average adduct level of 161 compared with a level of 81 for those who started smoking later than 20 years of age.

In addition, DNA adduct levels in lung tissue correlated statistically with DNA adduct levels in circulating blood cells.

"To our knowledge, no other study has considered age at smoking initiation as a potential predictor of tobacco smoke-related DNA damage in former smokers," Dr. Wiencke and colleagues write.

They suggest that "...smoking during adolescence may produce physiologic changes that lead to increased DNA adduct persistence or...young smokers may be markedly susceptible to DNA adduct formation and have higher adduct burdens after they quit smoking than those who started smoking later in life."

In an accompanying editorial, Drs. Margaret Spitz, Mariza de Andrade, and John Di Giovanni, of The University of Texas M.D. Anderson Cancer Center in Houston, point out that "[t]he ability to identify current and former smokers with the highest risks of developing cancer has substantial preventive implications."

"This report perhaps fits one more piece into the lung cancer risk assessment puzzle," they conclude.

J Natl Cancer Inst 1999;91:614-619.

-Westport Newsroom 203 319 2700

For a lot more information about tobacco dependence and smoking cessation, check out my Ask DrSteve web site, conveniently hyperlinked below. Good luck!

Steve Adelman, M.D. (a.k.a. DrSteve)

This information is for general medical education purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.

Keywords: teen smoking, lung cancer, carcinogenesis

• Ask DrSteve: The Real Story About Smoking, Drinking & Getting High

[The Addiction Forum]      [The Addiction Forum Archives]