Breast cancer remains the most common cancer among women worldwide, with environmental and lifestyle factors accounting for the majority of cases (90-95%). One of the major contributors to the rising number of breast cancer diagnoses is smoking, which has been linked to a higher risk of developing the disease, particularly among younger women. Experts in the field highlight the profound impact that smoking can have on breast cancer risk and other related health complications.
According to Dr. Palaniappan Ramanathan, Senior Consultant, Surgical Oncology, Apollo Cancer Centre, Bangalore, cigarette smoke contains over 7,000 chemicals, of which 70 are known carcinogens. These harmful chemicals damage DNA and disrupt the body’s natural repair mechanisms, increasing the likelihood of cancer development. “Smoking before the age of 17, around the time of a woman’s first menstrual cycle, is particularly concerning, as it has been associated with a 24% increased risk of breast cancer,” explains Dr. Ramanathan.
Furthermore, prolonged smoking over a span of more than 10 years and smoking over 25 cigarettes a day significantly raises the risk of developing breast cancer. Dr. Ramanathan also points out that combining smoking with alcohol consumption further compounds this risk. Alarmingly, even women who have quit smoking for up to 10 years still have a 28% higher risk of breast cancer compared to non-smokers. Additionally, exposure to second-hand smoke, or passive smoking, can also elevate a woman’s chances of developing breast cancer.
Smoking not only increases the risk of breast cancer, but it also negatively affects the outcome of cancer treatment. As Dr. Ramanathan notes, “Smoking causes poorer response to cancer treatments and increases the complications associated with them.”
Dr. Rucha Kaushik, Consultant Breast Cancer Surgeon at P.D. Hinduja Hospital and Medical Research Centre, Mahim, adds that smoking is a significant modifiable risk factor for breast cancer. She emphasizes that the risk depends on factors such as smoking history, age of initiation, duration, and exposure to passive smoking. “If women quit smoking, their risk will reduce significantly compared to those who continue smoking,” says Dr. Kaushik.
The prevalence of tobacco use in India is concerning, with 32.8% of the population using tobacco. Of this group, 12.6% are smokers, while the remaining majority use smokeless forms of tobacco, such as mishri and ghutka, which are especially prevalent in lower socioeconomic groups. Dr. Kaushik points out that many women who smoke are also likely to consume alcohol and have higher body mass indices (BMI), all of which further elevate their risk of developing breast cancer. “In the NIH-AARP diet and health study, current and former smokers had a greater risk of breast cancer compared with those who never smoked,” she adds.
In addition to its cancer-causing effects, smoking also damages breast tissue in other ways. It can cause a loss of elasticity in the breasts, leading to sagging. Smoking is also associated with non-cancerous breast conditions, such as duct ectasia—a condition involving the widening and inflammation of milk ducts, which can be painful and negatively affect quality of life.
Another common inflammatory breast condition linked to smoking is periductal mastitis, which, while non-cancerous, can lead to repeated infections, pus formation, and the creation of discharging sinuses if left untreated. “Overall, smoking is not good for your physical health, even though it might provide a false sense of comfort at the mental or emotional level,” warns Dr. Kaushik.
In conclusion, while smoking might seem to offer some emotional relief, the long-term consequences on physical health—particularly the increased risk of breast cancer—are significant. Quitting smoking and reducing exposure to second-hand smoke are crucial steps women can take to lower their breast cancer risk and protect their overall health.
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