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Is There Such a Thing as a Fit Smoker?

I mean, shouldn’t your toned butt kick all those butts’ butts?

Smokers determined to give up the fix will inevitably entertain the fantasy that there may be an easier way. The idea is this: If you’re super fit, exercise and eat well, maybe, just maybe, you can keep smoking because it will “cancel out” the risks. Or at least it will minimize them, effectively reducing your chances of lung cancer. Sounds logical, right? How can it not be better to be fit and smoke than not fit and smoke?

“People who work out on a regular basis do lower the risk of lung cancer and heart attack,” explains Tamir Katz, physician and co-author, along with Hila Katz, of A Smoker’s Guide to Health and Fitness. “If other parts of your life are healthy, you could reduce the chance of heart disease and cancer. It doesn’t, though, mean you can keep on smoking and rely on that.”

Katz is the rare doctor who discusses healthfulness alongside smoking, not because he thinks smoking is healthy or safe, or that it could undo the damage of smoking, or that smoking isn’t bad if you prop yourself up with other healthy goals — he makes it clear that smokers should quit. But because he has numerous patients who smoke and who care about their health, and he wanted to guide them in adopting healthier practices. 

“It’s not that I promote smoking,” Katz explains. “I don’t. I just have a lot of patients who don’t want to quit smoking, and I like to meet them halfway. Just like if your diet isn’t 100 percent, you can work out. So I looked at what people can do. One part of the book is how to quit smoking, but it’s also about what you can do to optimize your health if you do smoke.” For instance, exercise was recently found to reduce the risk of Chronic Obstructive Pulmonary Disease, or COPD, by 10 percent.

“I smoke,” thirtysomething Adam tells me. “A lot. I’m not thrilled about it, but I do enjoy it. I manage my weight with racquetball, decent real foods, tea, coffee and alcohol. I also generally don’t eat anything before noon or after 7 p.m., which is technically intermittent fasting.”

On a Reddit thread asking if you can be physically fit and still be a smoker, there are a couple of Adam-esque replies, but plenty of them expose the paradox of trying to be healthful while still keeping up the habit: 

But even though smoking notoriously strains your ability to work out as effectively by reducing the amount of oxygen that travels to the heart and other muscles, big-time athletes have been known to reward themselves with cigarettes, such as 1984 Olympic silver medal hurdler Shirley Strong and many British soccer players. Professional baseball and hockey players have long smoked, merely switching to smokeless tobacco after bans on cigarettes. Not to mention, wellness guru Gwyneth Paltrow still lights up in spite of her entire brand centering around restrictive diets and only-the-cleanest products.

Many fit smokers cite two major justifications for their habit. For one — the lucky people who smoke their whole lives but whose lungs remain mysteriously healthy. The problem here is that those smokers generally have a gene mutation that reduces their risk of COPD. So it’s not that their lungs aren’t damaged, it’s just not to the extent smokers’ lungs are. The second justification: The fact that smoking alleviates certain health conditions. For example, it’s better for symptoms of ulcerative colitis. And people who smoke a ton don’t usually get Parkinson’s.

Obviously, though, these aren’t slam dunk reasons to keep toking, and once again, the best choice is to not smoke. But if you still do, it seems irrational to discount eating well or moving around a bit until you quit — even if you never do. As such, Katz tells patients that basically any sort of exercise will reduce the risk of many diseases. He also encourages them to eat a healthy diet, something akin to the Mediterranean diet, which is heavy on fruits and vegetables and low in processed foods and meats, white sugar and flour (all of which can mitigate some of the damage done by smoking).

A third recommendation he makes is that his patients should look at mental health. “A lot of people smoke out of stress, or essentially untreated mental health,” he explains. “If you treat the issues, like being anxious, depressed or stressed out, and you treat it in a healthy way, they’re more likely to not rely on smoking.”

When smoker Dan Buyanovsky decided to quit for a while, he succeeded for long enough, alongside working out and eating well, that he decided to pick back up a little casual smoking. He pulled it off, so he set out to chronicle whether he could still call himself healthy so long as he had a few cigs a day. An addiction specialist, however, told him that there’s simply no way to game smoking, and to truly protecting himself from harm. A personal trainer firmly added that it quite literally contradicts the effort, suggesting a zero-sum game. 

Katz, though, says he doesn’t understand the point in thinking this way, aside from the fact, as I note, that there seems to be a fear of anything that even implies it’s somehow okay to smoke when it isn’t. “Smoking is very bad,” he explains. “I just don’t like looking at life in absolutes. By that logic, if you smoke, you should also eat hot dogs and donuts and never work out. That’s stupid. Why throw away everything just because you still smoke? If you can’t quit now, or don’t want to now, why not try to promote healthy behaviors? I don’t see a downside. I’m not saying a smoker is a healthy person, but a smoker can promote healthy behaviors and mitigate the effects.”

In his mind, it’s similar to giving addicts clean needles or condoms to someone having high-risk sex. “If you have someone who is making poor choices in terms of high-risk sexual behavior or using drugs, you still want to help that person instead of shunning or judging,” Katz believes. “Our job is to help people and provide information, not to judge them because they don’t have good habits or make good choices.”