When to tell your doctor you're a 'smoker'

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The question on medical history questionnaires can cause some people pause: “Are you a smoker? Have you been a smoker?”


How to define “smoker”


As far as your health care team is concerned, you’ve been a smoker if you’ve done any type of smoking in the past. Whether that was a few clove cigarettes every weekend in college, inhaling hookah a few times a year, marijuana, vaping or using cigarettes, it all falls under the umbrella of “smoking,” and it’s important for your doctor to know if you’re smoking now or have in the past.


You also should have a conversation with your doctor about the type of smoking you’ve done, because different types of inhalants can have different short- and long-term health effects. Nicotine poses certain risks, for example, and using e-cigarettes/vaping can lead to or aggravate certain lung diseases, where tobacco can present completely different health implications.


Does it matter how long ago you started smoking?


The further in the past you quit smoking, the less risk it poses to your health. For example, if you haven’t smoked in more than 15 years, it’s unlikely your doctor or other care provider would recommend a lung cancer screening. It’s still important to know whether you ever smoked, though.


The risks if you don’t tell your doctor you’ve been a smoker


If you ever develop lung symptoms, your doctor needs to know what you’ve inhaled in the past. There may be health conditions associated with that smoking that they wouldn’t consider if they didn’t know about your history, and certain tests they’ll order to better diagnose the problem.


Regardless of your smoking history, your doctor isn’t there to judge you. They want a complete picture of your health so that they can help you reach your best health as a unique individual. Every piece of your personal health history helps you and your care provider become better partners in that journey toward optimal health.


Randell Wexler, MD, is a primary care physician at The Ohio State University Wexner Medical Center and a professor in the Ohio State College of Medicine.