A landmark pooled analysis of 302,522 adults across 22 longitudinal cohort studies has quantified a sobering reality: smoking as few as 2 to 5 cigarettes per day elevates heart failure risk by 50% and all-cause mortality by 60% compared to never-smokers. This analysis, published in PLOS Medicine and spanning up to 30 years of follow-up data with over 125,000 documented deaths, reveals that the cardiovascular risk curve is nonlinear—the steepest increase occurs between zero and five cigarettes daily.
The dose-response relationship demonstrates conclusively that there is no safe threshold for smoking. Even light smoking carries substantial health consequences. These findings challenge the notion that “cutting back” offers meaningful cardiovascular protection, highlighting the distinction between harm reduction and actual risk mitigation.
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