NEW YORK (Reuters Health) - Smokers who think they will cheat death by puffing away on fewer cigarettes or not inhaling the noxious smoke better think again.

New research from Denmark suggests that women who smoke as few as 3 to 5 cigarettes a day may double their risk for a heart attack. And men may suffer the same fate smoking 6 to 9 cigarettes a day, according to the report published in the August issue of the Journal of Epidemiology and Community Health.

Although the adverse health effects of smoking are well known, some smokers assume that smoking just a few cigarettes or smoking without inhaling "is not hazardous," write Dr. Eva Prescott of the Institute of Preventive Medicine in Copenhagen, and colleagues.

While most previous studies have uncovered a host of health problems associated with smoking as many as 10, 15 and 25 cigarettes a day, few have examined the adverse health effects attributed to lighting up just a few times a day.

To investigate, the team evaluated the health and smoking habits of over 12,000 men and women over a 22-year period. During this time, 476 women and 872 men had a heart attack and 2,305 and 2,883, respectively, died.

Women who smoked 3 to 5 cigarettes per day were 2.14 times as likely to have a heart attack and 1.86 times as likely to die from any cause during the study than nonsmokers, the authors report.

Men who smoked 6 to 9 cigarettes per were 2.10 times as likely to have a heart attack and 1.76 times as likely to die of any cause during the study period than nonsmokers.

Risks of having a heart attack were also increased for those who puffed on cigarettes but said they didn't inhale the smoke.

"The study emphasizes the importance of recognizing that even very limited tobacco consumption has detrimental effects," the authors conclude.

SOURCE: Journal of Epidemiology and Community Health 2002;56:702-706.

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