How Smoking Leads to A Sedentary Lifestyle

Let’s start off by defining a “sedentary lifestyle”. In a medical sense this is any activity using less than 1.5 metabolic equivalents (METs). Light physical exercise is between 1.5 and 3 METs, moderate between 3 and 6 METs, and vigorous activity is anything over 6 METs. Common activities associated with “sedentary behaviour” that meet the METs criteria include sitting down, watching television, driving, using computers or reading.

New research has highlighted how dangerous sedentary behaviour can be for you. Some scientists go as far to say that “sitting is the new smoking”. By this, they mean that people are not only actively harming themselves by smoking or eating and drinking too much, they are passively harming themselves by being inactive for large parts of the day.

It’s been well established that smoking damages your health; it increases the risk of lung and other cancers, increases atherosclerosis leading to heart disease and damages the air exchange mechanism in the lungs, causing respiratory diseases. When considering day to day life, smokers have less endurance, poorer physical performance and increased rates of injury and complications. A number of physical endurance studies have also shown that smokers reach exhaustion before non-smokers, and can’t run as far or as fast either.

Although the general health risks of smoking are widely publicised, the dangers of low levels of physical activity and exercise have not been highlighted enough.

The Dangers of a Sedentary Lifestyle

Sedentary behaviour seems to be increasing our risk of cardiovascular problems such as heart attacks or strokes – and the effect is not only due to lack of vigorous exercise. Scientists have postulated that sitting or lying around too much might independently cause problems with circulation, increases in blood pressure, decreases in your glucose tolerance and reductions in your good cholesterol (HDL). This increase in risk will still be there even if you do your exercise after a full day of being inactive.

Interestingly, research has also shown that different factors have a cumulative or “stacking” effect. Take, for example, smoking: if you smoke, you are more likely to be sedentary – this is especially the case post-50 years old. Therefore, you are now facing two major risk factors for your cardiovascular health instead of one.

The causative mechanism between smoking and sedentary behaviour isn’t clear, but there are some likely explanations. Nicotine has a well-known reward pathway in the brain, and we all know that it is addictive. Perhaps the tendency for smokers to be sedentary comes from the fact that they are substituting reward mechanisms that they would get from exercise and activity (which release endorphins, AKA feel-good hormones) with nicotine. This might lead to a loss of motivation towards physical activity.

How to Motivate Yourself to Quit Smoking

When patients come to see me about quitting or even when I opportunistically ask them about it, I have noticed some distinct patterns. When someone wants to quit, the main motivation is usually declining health. The irony is that, by this stage, a lot of damage has already been done.

When someone doesn’t want to quit, I usually hear “I’ve been smoking for 20 years doctor – nothing’s happened to me!” or “I tried quitting once and I felt worse doctor.” Or a combination of the two. I ask people what they’ve tried before and look to figure out where they went wrong. One lady even told me she put her nicotine patches on at night before bed and took them off in the morning! Before I go into advising people about the methods of quitting, I need more information so I can tailor my approach to the individual.

The most important questions you need to ask yourself in quitting smoking are how and why. You need a powerful, personal reason to quit and you need to know that you can follow through. A useful fact for me is discovering what type of prospective quitter my patient is: I will ask a person to rate, on a scale of 1-10, how important quitting smoking is to them and then how confident they are that they will be able to quit smoking. This can tell me a lot about how successful they will be. For example, say you are extremely confident that you can quit, but you don’t think it’s very important. I would ask “what would make it more important to you?” It could be the emotional aspect of your loved ones asking you to stop, or something personal like finding it harder to take the dog for a walk each morning. If quitting is very important to you but you don’t feel you’ll be able to pull it off, I’d ask “what would it take to make you feel more confident?” It could be your partner quitting at the same time or maybe kicking a smaller habit first.

Time To Make A Decision

This approach and the facts we already know underline the truth; that one must accept a “smoking” life or a “smoke-free” life. No compromise will do, and like two boats heading out to sea at slightly different angles, you will end up in a vastly different place depending on which one you choose.

Your doctor or nurse can give you experienced advice, pharmacological help and a support network to make sure you finally kick the habit- use us, that’s what we are here for. Know what your motivation is, know yourself and pick the right time.

Jet Khasriya

By Dr Jet Khasriya, is an NHS-registered and private GP for GPDQ, the UK’s first doctor-on-demand app. Visit or click the social icons below to learn more.