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Pack Year Associations


  • Wrinkling of skin                                    > 50 pack years

  • Colorectal cancer                                  > 25 pack years

  • Lung cancer                                          > 30 pack years (20 times normal risk)

  • Macular degeneration                           > 40 pack years

  • Prostate cancer under 65 years           > 40 pack years (twice the risk of aggressive cancer)

  • Rheumatoid arthritis                             > 40 pack years

  • Ischaemic heart disease                       25% increase risk with 12-26 pack years


Older women with > 11 pack years have a 40% increase in breast cancer.

Anaesthetic care beds are often needed for patients with > 20-25 pack years.

Parkinson’s disease and endometrial cancer is less likely with > 10 pack years