Smoking immediately upon waking may increase risk of lung and oral cancer

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'Wake-Up' Cigarette May Raise Risk for Lung, Mouth Cancers

The sooner a person smokes a cigarette upon waking in the morning, the more likely he or she is to acquire lung or oral cancer, a new study reveals.

Penn State researchers analyzed data from nearly 2,000 adult smokers who took part in the U.S. National Health and Nutrition Examination Survey. The participants provided blood samples and information about their smoking behaviour.

The investigators found that about 32% of the participants smoked their first cigarette of the day within five minutes of waking. Among the others, 31% smoked within 6 to 30 minutes, 18% smoked within 31 to 60 minutes, and 19% smoked more than an hour after waking.

Highest levels of cancer-linked substance found in blood of those who light up first thing in morning.

People who had a cigarette immediately after waking had higher levels of NNAL -- a byproduct of a tobacco-specific cancer-causing substance called NNK -- in their blood than those who smoked a half hour or more after waking, regardless of how many cigarettes they smoked in a day, the study authors reported.

The research team also found that NNAL levels in the participants' blood was also associated with factors such as their age, their gender, the age they started smoking, and whether or not another smoker lived in their home.

"Most importantly, we found that NNAL level was highest among people who smoked the soonest upon waking, regardless of the frequency of smoking and other factors that predict NNAL concentrations," study co-author Steven Branstetter, an assistant professor of biobehavioral health, said in a Penn State news release.

"We believe these people who smoke sooner after waking inhale more deeply and more thoroughly, which could explain the higher levels of NNAL in their blood, as well as their higher risk of developing oral or lung cancer," he added. "As a result, time to first cigarette might be an important factor in the identification of high-risk smokers and in the development of interventions targeted toward early morning smokers."

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The above story is based on the March 29, 2013 news release by Penn StateUniversity.

The study was published in the journal Cancer Epidemiology, Biomarkers and Prevention:

Branstetter SA, Muscat JE. Time to First Cigarette and 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanol (NNAL) Levels in Adult Smokers; National Health and Nutrition Examination Survey (NHANES), 2007–2010.Cancer Epidemiol Biomarkers Prev April 2013 22:615-622; doi:10.1158/1055-9965.EPI-12-0842

More information

The U.S. National Cancer Institute has more about the harms of smoking.