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Can Smoking Cause Multiple Myeloma? What We Know

Medically reviewed by Fatima Sharif, MBBS, FCPS
Written by Nyaka Mwanza
Updated on March 17, 2025

Thanks to years of cancer research and public health warnings, most people know that smoking tobacco is a leading cause of cancer deaths. Smoking tobacco puts people at a higher risk for most types of cancer — but multiple myeloma is a rare exception. Smoking does not cause multiple myeloma or increase the relative risk of developing it (the likelihood of developing the condition compared to someone who is not exposed to tobacco).

However, smoking still harms your overall health, can interfere with multiple myeloma treatments, and may worsen symptoms.

Here’s what to know about smoking, multiple myeloma, and your health.

What Is Multiple Multiple Myeloma?

Multiple myeloma is a type of blood cancer related to leukemia and lymphoma. More specifically, multiple myeloma is a type of cancer that occurs when abnormal plasma cells (cancerous myeloma cells) grow out of control. These cancerous cells crowd out and outnumber healthy plasma cells, which normally help fight infections. Multiple myeloma can also cause tumors called plasmacytomas, which can form anywhere in the body.

Is There a Connection Between Smoking and Multiple Myeloma?

Research shows that smoking tobacco does not directly cause multiple myeloma. Scientists aren’t sure what causes multiple myeloma, but they believe environmental and genetic factors play a role. Environmental factors may include exposure to certain pesticides, workplace chemicals, or having excess body weight.

Interestingly, tobacco smoke is not linked to multiple myeloma. A person’s smoking status doesn’t affect their outlook if they are diagnosed with the disease.

Smoking Increases Some Multiple Myeloma Risk Factors

Recent research suggests that heavy smoking — defined as smoking 20 cigarettes per day for over 30 years — can increase your risk of developing monoclonal gammopathy of undetermined significance (MGUS). MGUS is a known risk factor for multiple myeloma. Both multiple myeloma and MGUS are plasma cell diseases.

When you have MGUS, your bone marrow produces a protein called monoclonal protein or M protein. While MGUS itself doesn’t usually cause symptoms, about 1 percent of people with MGUS develop blood cancers like multiple myeloma or other serious diseases.

Is It Safe To Smoke Tobacco?

No amount or type of tobacco use is safe. Tobacco smoke contains at least 69 cancer-causing agents, including arsenic, benzene, and formaldehyde.

According to the World Health Organization, smoking is one of the world’s biggest public health threats. Smoking tobacco causes more than 7 million deaths worldwide each year, contributes to nearly one-third of all cancer deaths, and costs the U.S. hundreds of billions of dollars annually in medical care and lost productivity.

While smoking doesn’t directly increase your risk of multiple myeloma, it harms your overall health, increases your risk of developing other types of cancer, and can interfere with your cancer treatment. Smoking also poses a secondhand health risk to those around you.

Smokeless Tobacco Products

Smokeless tobacco products — such as chewing tobacco, heated tobacco products, and e-cigarettes (vaping) — are often seen as safer alternatives to smoking. However, they are not safe. For example, e-cigarettes expose users to toxic chemicals, cause inflammation, and can damage cell DNA, increasing cancer risk.

Why Should You Quit Smoking?

Even though smoking isn’t directly linked to multiple myeloma, quitting is one of the best things you can do for yourself. Tobacco use is addictive, expensive, and dangerous. If you’re at increased risk for or have been diagnosed with multiple myeloma, quitting smoking can improve your mental and physical health.

Improving Multiple Myeloma Treatment Outcomes

If you’re being treated for multiple myeloma, quitting smoking can make your treatment more effective. Quitting smoking can also help your body recover faster after harsh treatments like chemotherapy, a complex procedure like a stem cell transplant, or surgery.

Smoking tobacco can make chemotherapy drugs more toxic or less effective. The toxic chemicals in tobacco smoke can also interfere with cancer treatments, leading to delays, incorrect dosing, or problems sticking to your treatment plan.

Avoiding Multiple Myeloma Complications

Multiple myeloma can cause other health issues, such as kidney problems, low blood cell counts, and anemia. These conditions, combined with multiple myeloma, can make breathing harder. Smoking frequently causes breathing and lung issues and can worsen existing breathing problems, making it even more important to quit.

Reducing Cancer Treatment Side Effects

Multiple myeloma treatments like chemotherapy or radiation (radiotherapy) often cause side effects like nausea, fatigue, and pain. Smoking can make these side effects worse and last longer. Quitting smoking can also lower your risk of infections, which are common during chemotherapy and immunotherapy.

Saving Money

Smoking isn’t just bad for your health — it’s also expensive. If you smoke a pack of cigarettes a day, you could save up to $2,500 a year, depending on where you live.

This doesn’t include other smoking-related expenses, like higher healthcare costs and insurance premiums. While you can’t put a price on your health, quitting smoking can save you money.

Cutting Down vs. Quitting Smoking Tobacco

There is no safe way to use tobacco. But, if you smoke, cutting down is a good first step toward quitting for good.

Talk to Your Healthcare Team

It might feel hard, but talk to your doctors about your smoking habits. They won’t judge you — they’re there to help. Your cancer treatment team can also support you in quitting.

Stop-Smoking Resources

Quitting tobacco is hard because nicotine is highly addictive. In most cases, tobacco use isn’t a choice — it’s an addiction. But quitting is possible, and there are many free resources to help you. Remember, it’s never too late to quit smoking.

Talk With Others Who Understand

MyMyelomaTeam is the social network for people with multiple myeloma and their loved ones. On MyMyelomaTeam, more than 28,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple myeloma.

Are you living with multiple myeloma? Has your multiple myeloma improved since you quit smoking? Share your experience in the comments below, or start a conversation by posting on your Activities page.

References
  1. Health Effects of Cigarettes: Cancer — Centers for Disease Control and Prevention
  2. Tobacco Smoking and Risk of Multiple Myeloma: A Meta-Analysis of 40 Observational Studies — International Journal of Cancer
  3. A Pooled Analysis of Cigarette Smoking and Risk of Multiple Myeloma From the International Multiple Myeloma Consortium — Cancer Epidemiology, Biomarkers, & Prevention
  4. Relative Risk — National Cancer Institute
  5. Benefits of Quitting Smoking — Centers for Disease Control and Prevention
  6. Leukemia, Lymphoma, and Multiple Myeloma — Temple Health
  7. Understanding Multiple Myeloma — Multiple Myeloma Research Foundation
  8. Multiple Myeloma/Plasmacytoma — American Academy of Orthopaedic Surgeons
  9. Multiple Myeloma in an Agricultural Worker Exposed to Pesticides — Cureus
  10. What Causes Multiple Myeloma? — American Cancer Society
  11. Excess Body Weight and Cancer Risk — American Cancer Society
  12. Mass Spectrometry-Detected MGUS Is Associated With Obesity and Other Novel Modifiable Risk Factors in a High-Risk Population — Blood Advances
  13. Risk Factors for Multiple Myeloma — American Cancer Society
  14. Monoclonal Gammopathy of Undetermined Significance (MGUS) — Mayo Clinic
  15. Is Any Type of Tobacco Product Safe? — American Cancer Society
  16. Harmful Chemicals in Tobacco Products — American Cancer Society
  17. Tobacco — World Health Organization
  18. E-Cigarettes Induce Toxicological Effects That Can Raise the Cancer Risk — Scientific Reports
  19. Helping Smokers Quit Saves Money — American Lung Association
  20. Continued Smoking May Affect Cancer Patients’ Treatments, Symptoms, and Side Effects — Cancer Treatment Centers of America
  21. Multiple Myeloma — Mayo Clinic
  22. Signs and Symptoms of Multiple Myeloma — American Cancer Society
  23. The Effect of Cigarette Smoking on Cancer Treatment-Related Side Effects — The Oncologist
  24. Infection and Neutropenia During Cancer Treatment — National Cancer Institute
  25. Economic Trends in Tobacco — Centers for Disease Control and Prevention
  26. Quitting Smoking or Smokeless Tobacco — American Cancer Society
  27. How To Quit Using Tobacco — American Cancer Society
  28. Benefits of Quitting Tobacco if You Have Cancer — American Cancer Society
  29. Association of a Comprehensive Smoking Cessation Program With Smoking Abstinence Among Patients With Cancer — JAMA Network Open
  30. Stopping Tobacco Use After a Cancer Diagnosis — American Society of Clinical Oncology
  31. Plasma Cell Neoplasms (Including Multiple Myeloma) Treatment (PDQ) — Patient Version — National Cancer Institute
  32. Smoking and Tobacco Use — Centers for Disease Control and Prevention
  33. Health Consequences of Smoking, Surgeon General Fact Sheet — HHS.gov
  34. Relative Risk — StatPearls

Fatima Sharif, MBBS, FCPS graduated from Aga Khan University, Pakistan, in 2017 after completing medical school. Learn more about her here.
Nyaka Mwanza has worked with large global health nonprofits focused on improving health outcomes for women and children. Learn more about her here.

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