Smoking. Is it a sin?

Do you smoke cigarettes? If yes, read on; you may need a “light.” If no, continue reading as well; you may be able to “enlighten” someone else. Is smoking really as bad for your health as they say? And if my body is a temple of the Holy Spirit, should I continue to defile it with smoking? Am I serving the Lord with my body if I knowingly harm it? Is suicide really a sin, especially if you do it slowly? Come on now, you may say, if smoking is that bad, why do so many church members smoke; even some ministers, some elders, some deacons, some Christian school teachers, etc. Aren’t they all serving the Lord in their respective offices and duties? Of course they are. The question is not whether we can still serve the Lord when we smoke or whether we can still serve the Lord when we sin—We all sin—but rather, what can we do to fight our sins in order that we can serve the Lord better. It makes a big difference if we don’t know whether we are committing a sin, or if we don’t care when we know and live in sin. I’m afraid that most smokers stick their head in the sand like ostriches and don’t want to know about the effects of smoking. And once they have developed an illness directly related to their smoking, such as lung cancer, heart disease, chronic lung disease, etc., who will tell them that they are to blame themselves for their illness?

Smoking and cancer

Recently my father in The Netherlands had major chest surgery. His right lung was removed. They could not remove all tumor tissue in the lymph nodes, and he is presently receiving radiation therapy for the remaining cancerous cells. He smoked two packs of cigarettes a day for at least forty years. Didn’t he know what smoking can do to you? Yes and no. Twenty years ago not many people were concerned about smoking. It wasn’t until 1964 that the U.S. Surgeon General issued his first report on the health consequences of smoking. Since that time extensive research and a large data base on the effects of smoking has been accumulated by scientists throughout the world. There is no longer any doubt that cigarette smokers have a higher death rate than non-smokers.

In his recently published 1982 report¹ to the U.S. Congress on the health consequences of smoking, the Surgeon General identifies cigarette smoking as the major single cause of cancer mortality in the United States. Cancer is the second most frequent cause of death in the United States; it will account for an estimated 430,000 deaths this year. Tobacco’s contribution to cancer deaths is currently estimated to be 30%. This means that 129,000 Americans are likely to die of cancer this year because of the higher overall cancer death rates for smokers as compared to nonsmokers. Cigarette smokers have total cancer death rates that are two times greater than those for non-smokers. Heavy smokers (those who smoke more than one pack a day) have three to four times greater excess risk of cancer mortality.

     

Lung cancer and smoking

Cigarette smoking is the major cause of lung cancer. Lung cancer alone accounts for 25% of all cancer deaths in the U.S.; it is estimated that 85% of lung cancer cases are due to cigarette smoking. The number of lung cancer deaths in the United States increased from 18,313 in 1950 to 90,828 in 1977. The American Cancer Society estimates that 111,000 persons will die of lung cancer in the U.S. in 1982 –80,000 men and 31,000 women. The lung cancer death rate for women is currently rising faster than for men, reflecting the more recent adoption of smoking by large numbers of women. If this trend continues, the lung cancer death rate for women will soon surpass that of breast cancer, currently the leading cause of cancer mortality in women. The five-year survival rate for lung cancer is less than 10%. The rate has not changed appreciably in over 15 years.

How about those who don’t smoke but who are exposed to the smoke of others (passive or involuntary smoking)? In 1981 two epidemiologic studies found a statistically significant correlation between involuntary smoking and lung cancer risk in nonsmoking wives of men who smoked. In other words, the risk of lung cancer in nonsmokers goes up when exposed to the smoke of smokers. What about those smoke-laden ecclesiastical meeting rooms in which you can literally cut the air? Is this consistent with “love your neighbor as yourself”?

Cancer of the larynx, oral cavity, and esophagus

Cigarette smoking is also a major cause of cancer of the larynx (voice box), oral cavity (mouth), and esophagus (gullet). Smokers have a mortality risk ratio for laryngeal cancer at least five times greater than that of nonsmokers. Heavy smokers have laryngeal-cancer mortality ratios fifteen-thirty times those for nonsmokers. An estimated 40,000 individuals will develop laryngeal and oral cancer, which will result in approximately 13,000 deaths this year in the United States. These types of cancers are also strongly associated with use of cigars and pipes in addition to cigarettes. All three forms of tobacco use carry approximately the same excess relative risk of at least five-fold. The longterm use of snuff appears to be a factor in the development of oral cancer, particularly of the cheek and gum.

This year 8,300 deaths are expected due to cancer of the esophagus; only about 4% of patients are alive five years after diagnosis, and most die within six months. Patients with this form of cancer have one of the poorest survival rates for any form of cancer. The use of alcohol in conjunction with smoking acts synergistically to increase the risk of cancer of the larynx, oral cavity, and the esophagus.

Cancer of the bladder, pancreas, and kidney

Cigarette smoking is a contributory factor for the development of cancer of the bladder, pancreas, and kidney. The term “contributory factor” by no means excludes the possibility of a direct role of smoking in the causation of these types of cancer. The consistent demonstration of an excess risk of cancer of these sites among smokers in comparison with nonsmokers suggests that if smoking were not to exist in these populations, a measurable proportion of these diseases would not occur. Over 50,000 Americans are expected to develop bladder and kidney cancer this year; about 20,000 will die. The five-year survival rates are approximately 50% to 60%. Numerous investigators have estimated that between 30% and 40% of cases of bladder cancer are smoking related, with slightly higher estimates for males than for females.

Approximately 24,000 people in the U.S. will develop cancer of the pancreas this year, and there will be an estimated 22,000 deaths from pancreatic cancer. Like cancer of the lung and esophagus, pancreatic cancer is often fatal. Patients with this form of cancer have one of the poorest five-year survival rates for any form of cancer. While few estimates are available as to the proportion of these deaths attributable to smoking, it would appear to be about 30%. Pancreatic cancer appears to be increasing at a more rapid rate than cancer of most other sites except the lung.

Stomach cancer

Numerous epidemiologic studies have noted a link between smoking and cancer of the stomach. This association is smaller than that noted between smoking and other cancer sites.

Cancer risks after you stop smoking

Although cigarette smoking is a cause of many forms of cancer, encouraging facts have been reported. Studies have shown that even after many years of smoking, stopping smoking reduces one’s cancer risk substantially compared with that of the continuing smoker. The more years one refrains from smoking cigarettes after stopping, the greater the reduction in excess cancer risk. Fifteen years after stopping cigarette smoking, for example, a former smoker’s lung-cancer risk is reduced to nearly the level observed for nonsmokers. This same reduction in cancer risk is observed for other cancer sites associated with smoking. There is no single action an individual can take to reduce the risk of cancer more effectively than to stop smoking—particularly smoking cigarettes.

Other health effects

Besides the direct relationship between cigarette smoking and lung cancer, there is also a proven relationship between cigarette smoking and coronary heart disease. In addition, the relationship between cigarette smoking and chronic obstructive lung disease (emphysema) has been well documented. Several conditions and illnesses related to smoking are enumerated elsewhere in this article.

Spiritual health

If there is still an “unbelieving Thomas” among us, will he continue to smoke until he can see the devastating effects of smoking in his own body before he will believe that smoking causes illness? What about the question which I raised before: Is smoking a sin? I trust that after reading this article and examining the facts you will agree with me that “cigarette smoking is dangerous to your health.” Not only your physical health, but even your spiritual health. For if I knowingly harm my body, doesn’t this constitute sin? And if I commit this sin many times day after day, year after year, shouldn’t I try my utmost to break with it? How do you do that? How do you quit smoking? It is pretty hard to quit. Maybe you’ve tried once or twice before. But did you ever pray to God to help you fight and overcome this sin? Did you ever pray for someone else who smokes and is trying to quit? I believe that the best way to quit smoking is to realize that it is a sin and that, if I love the Lord, in thankfulness for what He has done for me, I will quit committing this sin, for His sake.

Health effects of smoking

Do you know . . .

• that some 500,000 persons die annually in the United States and Canada because of smoking?
• that one’s life may be shortened 14 minutes for every cigarette smoked?
• that cigarette smoking is the major cause of lung cancer?
• that lung cancer is now the most common cancer among men?
• that lung cancer in women is rapidly increasing?
• that smoking is also a major cause of cancer of the larynx, the oral cavity, and the esophagus?
• that smoking contributes to the development of cancer of the bladder, pancreas, and kidney?
• that cigarette smokers have a much higher incidence and death rate from heart attacks than nonsmokers?
• that the incidence of coronary heart disease increases as the daily number of cigarettes smoked increases and that the incidence of heart disease decreases among those who quit smoking?
• that cigarette smokers have a higher death rate from cerebral vascular disorders (e.g. stroke) than do abstainers?
• that smoking causes constriction and narrowing of the blood vessels resulting in peripheral vascular disease?
• that smoking is the most common cause of chronic obstructive lung disease (emphysema)?
• that smoking is associated with an increased incidence of ulcers and death therefrom?
• that cigarette smoking during pregnancy has been shown to have adverse effects on the mother, the fetus, the newborn infant, and the child in later years?
• that smoking by pregnant women increases the risk of vaginal bleeding, miscarriage, premature delivery, fetal death, and reduces the birth weight of newborn infants?
• that children of smoking mothers are more susceptible to some adverse health effects such as bronchitis, pneumonia, and respiratory disease during early childhood?
• that parental smoking is associated with the sudden infant death syndrome?

^1“The Health Consequences of Smoking: Cancer. “A report of the Surgeon General. Rockford, Maryland: Public Health Service, U.S. Department of Health and Human Services, 1982. Copies of this report can be obtained by writing to: Office of Smoking and Health, Park Building, Room 1-58, 5600 Fishers Lane, Rockville, Maryland, U.S.A. 20857.

Walter D. Meester, M.D., Ph.D. FAACT., is the Head of the Clinical Toxicology Department of Blodgett Memorial Medical Center and Associate Clinical Professor, Department of Medicine at Michigan State University. He is also a long-time member of the Reformed Fellowship. This article appeared in March. 1982 REFORMED PERSPECTIVE, published at Winnipeg, Manitoba, Canada and is reprinted by permission.