Which of the most common of human vices—smoking, drinking or gambling—is the worst? The answer at a personal level is: to which am I addicted? Am I an alcoholic bewitched by the devil’s brew? Or do I gamble away every paycheck?

At the outset, we must state that when out of control, all three are addictions. However, of the three, smoking must be the worst habit. It is not only an addiction to nicotine but a killer in addition. It destroys health and is a major health epidemic. Cigarette smoking kills more Americans than trauma, alcohol, or other drugs and suicide, Murder and AIDS all put together. The financial cost is almost incalculable. Of all deaths among Americans, 20% are tobacco related. One third of all deaths due to cancer are tobacco related. Carcinogens are carried in the cigarette smoke one inhales. It causes cancer of many organs such as lung, throat, esophagus, liver, pancreas and bladder. Pulmonary disease such as emphysema, bronchitis and other lung diseases are also triggered. Heart disease and stroke occur because smoking promotes atherosclerosis. Also, carbon monoxide is bound to the red blood cell hemoglobin, so that oxygen is not carried to the periphery as in a non-smoker. Less oxygen is delivered.

The American Heart Association statistics demonstrate that there is a marked increase in risk among smokers for heart attack and stroke in both men and women who smoke. The data shows that almost 47 million Americans smoked in 2001. The numbers are generally around 20% for middle aged adults but even higher for those 18-24. For young Americans under 50, cigarette smoking is their greatest risk for developing cardiovascular diseases. This includes diseases we may not think of such a peripheral arterial disease and aneurysms. If you stop early, you eliminate much of the risk.

Reproduction in females is also affected by smoking (and alcohol). Smoking induces higher rates of miscarriage, as well as higher stillborn and infant deaths. In live born children prematurity and lower birth weight are documented more often in women who smoke cigarettes than non-smokers. Finally, we note the insidious effect of second hand smoke on people in the local environment. Harmful effects are well shown by the American Cancer Society. Lung cancer and other lung and heart diseases are increased by second hand smoke.

Why else is it the worst habit? It is now become very expensive with taxes per pack increasing exorbitantly. Cost per pack in some states is around 8-10 dollars a pack. Add that up for 4 packs a day ($40) per year: almost $15000. You smell. Smoking leaves its imprint on you, your hair, your breath and clothing. So to live longer and healthier, stop smoking. The earlier you quit, the better your chances of regaining good health. Live long and prosper.