I agree NCOT. Let's throw some statistics up. None of this is to bash anyone's choices to use steroids longterm or to smoke. Everything is a calculated risk, what we're willing to take on. And with any risk, some are not hit, while others are. Disclaimer aside, here they are:
Let's start with immunosuppressive medications (Imuran, 6mp, aza) and biologics (remicade, humira, simponi). The odds of cancers are 0.04 and 0.06 percent respectively.
Let's look at prednisone and osteoporosis (bone loss) over longterm use. Glucocorticosteroids (prednisone, uceris) induce a biphasic bone loss with a rapid initial phase of ∼10–15% during the first few months and a slower phase of ∼2–5% annually. The earliest changes of steroid‐induced bone loss can be detected in the lumbar spine (preferably lateral position). During long‐term (>3 month) use of steroids (>7.5 mg prednisone) bone loss occurs in ∼50% of patients, osteoporotic fractures in 25% of patients and osteonecrosis in some patients.
Source:
m.ndt.oxfordjournals.org/content/18/5/861.fullOn smoking risks. Fewer than 10 percent of lifelong smokers will get lung cancer (again, imuran, 6mp, remicade, and humira have 0.04 to 0.06 percent odds for cancers). Fewer yet will contract the long list of other cancers, such as throat or mouth cancers from smoking. ... Part of the problem of the misconception of real risks is the emphasis on smoking and lung cancer as the greater danger is from vascular diseases leading to heart attacks and stroke, which kill more smokers than all cancers combined... The life expectancy for a smoker in the United States is about
64, which is 14 years shorter than the national average (which includes smokers), according to the Centers for Disease Control and Prevention.
Source:
m.livescience.com/3093-smoking-myths-examined.htmlCertainly, I'd say that by the numbers/risk is higher with steroids or smoking than it is for immunosuppressive or biologic medications.