As more than 7,000 chemicals in each puff rapidly spread through the body to cause cellular damage in nearly every organ.
Think the occasional cigarette won't hurt? Even a bit of social smoking, or inhaling someone else's secondhand smoke, could be enough to block your arteries
and trigger a heart attack, says the newest surgeon general's report.
Lung cancer is what people usually fear from smoking, and yes, that can take years to strike. But Thursday's report says there's no doubt that tobacco smoke begins poisoning immediately — as more than 7,000 chemicals in each puff rapidly spread through the body to cause cellular damage in nearly every organ.
Interactive: The smoker's body
"That one puff on that cigarette could be the one that causes your heart attack," said Surgeon General Regina Benjamin.
Or the one that triggers someone else's: "I advise people to try to avoid being around smoking any way that you can," she said.
Stalled progress
About 443,000 Americans die from tobacco-caused illnesses every year. While the smoking rate has dropped dramatically since 1964, when the first surgeon general's report declared tobacco deadly, progress has stalled in the past decade.
About 46 million adults or one in five still smoke, and tens of millions more are regularly exposed to secondhand smoke. The government hoped to drop the smoking rate to 12 per cent by this year, a missed goal that's now been put off to 2020.
Thursday's report is the 30th issued by US surgeons general to warn the public about tobacco's risks.
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