The Healthspan Map · Habits (Ch4)
Tobacco / vaping — quit
What this is linked to
| Nutrient or lever | Direction | Strength | Evidence type | What was found | Source |
|---|---|---|---|---|---|
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces anxiety (SMD -0.37; effect comparable to antidepressants); guideline bodies establish smoking as harmful to mental health and debunk the "calming" belief. | Taylor et al. 2014, BMJ (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces anxiety (SMD -0.37; effect comparable to antidepressants); guideline bodies establish smoking as harmful to mental health and debunk the "calming" belief. | Change in mental health after smoking cessation: systematic review and meta-analysis, BMJ 2014 (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Emerging | Cohort / observational | Smoking is associated with increased fall risk (via frailty, bone and vascular effects). | Falls risk-factor meta-analysis (PMC11335697) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | RCT / meta-analysis | Current smoking accelerates cognitive decline and raises dementia risk (faster MMSE decline; AD RR ~1.8). | Anstey et al. 2007; CHARLS 2025 (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | RCT / meta-analysis | Current smoking accelerates cognitive decline and raises dementia risk (faster MMSE decline; AD RR ~1.8). | Anstey et al., "Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies", Am J Epidemiol 2007 (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Cohort / observational | Smokers show more insomnia, poor sleep quality, shorter sleep and daytime drowsiness; carbon monoxide also lowers oxygen delivery. | Smoking & sleep population study (WHO MONICA) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces depression (SMD -0.25); guideline bodies establish smoking as harmful to mental health. | Taylor et al. 2014, BMJ (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces depression (SMD -0.25); guideline bodies establish smoking as harmful to mental health. | Change in mental health after smoking cessation: systematic review and meta-analysis, BMJ 2014 (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Cohort / observational | Smoking weakens the lower esophageal sphincter, raising GERD and ulcer risk. | Smoking & GERD/peptic ulcer (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Emerging | Cohort / observational | Smoking is associated with increased migraine/headache frequency. | Migraine risk-factor literature (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | RCT / meta-analysis | Smoking causes acute blood-pressure spikes and vascular damage; cessation is a standard non-drug measure. | Non-drug BP management (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Smoking lowers HDL and oxidizes LDL, worsening cardiovascular risk; quitting raises HDL. | Lifestyle & lipids (Endotext) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Nicotine is a stimulant that raises arousal and, like caffeine, interferes with adenosine-driven sleep pressure. | Adenosine/nicotine & sleep (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | RCT / meta-analysis | Smoking causally raises chronic musculoskeletal pain (about 30% more back pain in smokers) and accelerates disc/muscle degeneration and delayed healing. | Smoking & chronic pain (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | RCT / meta-analysis | Smoking lowers bone density and raises fracture risk through reduced estrogen, impaired calcium absorption and direct effects on bone cells. | Modifiable risks (IOF) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Smoking worsens the microvascular damage and oxidative stress that injure peripheral nerves. | Diabetic neuropathy review (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Smoking is a major modifiable cause of erectile dysfunction and impairs sperm count, motility and DNA integrity, with broad fertility harms in both sexes. | Lifestyle modification & erectile dysfunction (PMC4291878) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Smoking is a major modifiable cause of erectile dysfunction and impairs sperm count, motility and DNA integrity, with broad fertility harms in both sexes. | US Surgeon General — The Health Consequences of Smoking (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Causal genetic evidence: smoking raised bacterial pneumonia (OR 2.14), chronic lower-respiratory disease (OR 2.29) and asthma-related pneumonia/sepsis (OR 3.64); it paralyses airway cilia and suppresses immune cells. | Smoking & respiratory infection Mendelian randomisation (Commun Biol 2021) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Cigarette smoke degrades collagen/elastin, depletes vitamin C, impairs wound healing and causes premature ageing and hair loss. | Smoking & skin (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Cohort / observational | Smoking increases OSA incidence/severity via airway inflammation, nasal resistance and collapsibility, and raises daytime sleepiness. | OSA & obesity review (PMC10876414) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces stress (SMD -0.27); guideline bodies establish smoking as harmful to mental health and officially debunk the "relieves stress" belief (withdrawal relief misattributed). | Taylor et al. 2014, BMJ (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | RCT / meta-analysis | Quitting smoking reduces stress (SMD -0.27); guideline bodies establish smoking as harmful to mental health and officially debunk the "relieves stress" belief (withdrawal relief misattributed). | Change in mental health after smoking cessation: systematic review and meta-analysis, BMJ 2014 (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Smoking interferes with iodide trapping at the Na⁺/I⁻ symporter and is linked to Graves’ disease and thyroid eye disease. | Diet in thyroid disorders review (PMC11451952) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Cohort / observational | Smoking is an established risk factor for tinnitus (vascular and ototoxic effects). | Tinnitus & cardiovascular risk (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Cohort / observational | Smoking directly causes insulin resistance and raises type 2 diabetes risk ~30-40%; it also increases central adiposity. | Tobacco, insulin resistance & T2D (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Smoking is a WHO-recognised causal risk factor for AMD (2–4× risk, onset ~5.5 years earlier) and for cataract; second-hand smoke doubles AMD risk. | WHO/IAPB smoking & vision brief (PMC10043916) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Review / narrative | Cigarette smoke impairs innate and adaptive immunity and raises inflammatory markers, increasing infection susceptibility. | Smoking & immunity (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Smoking is the leading cause of lung cancer and of COPD (chronic bronchitis and emphysema), harming nearly every organ. | US Surgeon General report / CDC (2014 onward) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Cohort / observational | Lung-cancer mortality rises nearly linearly with smoking, reaching relative risks above 40 in long-term heavy smokers. | Thun et al., "50-year trends in smoking-related mortality in the United States" (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Lung-cancer mortality rises nearly linearly with smoking, reaching relative risks above 40 in long-term heavy smokers. | US Surgeon General — The Health Consequences of Smoking (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Smoking causes coronary heart disease, stroke, heart failure and peripheral arterial disease. | US Surgeon General report / CDC (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Tobacco and e-cigarette aerosol drive endothelial dysfunction, thrombosis and atherosclerosis; smokers face 2-3x cardiovascular death risk and vaping is not harmless to vessels. | Smoking/e-cigarette cardiovascular studies (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Strong | Established clinical | Tobacco and e-cigarette aerosol drive endothelial dysfunction, thrombosis and atherosclerosis; smokers face 2-3x cardiovascular death risk and vaping is not harmless to vessels. | US Surgeon General — The Health Consequences of Smoking (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Established clinical | Smoking is a cause of cancers of the oral cavity, esophagus, pancreas and colorectum, and of peptic-ulcer disease. | US Surgeon General report / CDC (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Moderate | Systematic review | Current smokers have ~34% higher risk of incident chronic kidney disease (meta-analysis); smoking also accelerates liver fibrosis. | Smoking & CKD meta-analysis (PubMed 28339863) (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Emerging | Established clinical | Smoking impairs immune defenses and raises risk of pneumonia, tuberculosis and other infections. | US Surgeon General report (opens in a new tab) |
| Tobacco / vaping — quit | Do this | Emerging | Established clinical | Smoking accelerates skin aging and premature wrinkling through vascular and collagen damage. | US Surgeon General report (opens in a new tab) |