Nina Simone may have been onto something when she sang, "Don't smoke in bed." The amount of time it takes for you to smoke your first cigarette in the morning — whether you’re a light or heavy smoker — may have an effect on your risk for lung cancer, according to a new study.

Researchers reviewed data from the Environment and Genetics in Lung Cancer Etiology (EAGLE) study, examining current and former smokers in Italy. Participants were questioned about their smoking habits and history, as well as asked to respond to the question, “How soon after you wake up do you usually smoke your first cigarette of the day?” This was measured as “time to first cigarette” (TTFC).

“An individual smoker’s risk for developing lung or head and neck cancer may be related to how dependent they are on nicotine,” Dr. Michael B. Steinberg, editorial board member of HemOnc Today, said in an interview. “Asking a question like ‘How soon do you smoke in the morning?’ may be a way of getting at that information and giving an individual their own risk for developing cancer.”

Out of the 3,249 smokers from the EAGLE study, 1,812 of them were lung cancer patients, and 1,437 were control subjects. The researchers found that the lung cancer risk was significantly higher in people who reported shorter TTFC. Interestingly, risk of lung cancer in relation to TTFC was higher in lighter smokers compared to heavy smokers. “Assessing TTFC may improve lung cancer risk prediction and could be useful in lung cancer screening and smoking cessation programs,” the authors conclude.

Other studies, such as one conducted in Japan last year, also found a link between time to first cigarette and lung cancer. So pay attention, smokers — even if you don’t smoke one or two packs a day, but consider yourself an “occasional” smoker — the sooner you start inhaling tobacco in the morning, the more you’ll increase your risk for lung cancer.

One study completed by Joshua Muscat of the department of public health sciences at Penn State College of Medicine found a link between TTFC and both head and neck cancer. “There is clearly inter-individual variability in the way smokers regulate their nicotine intake per cigarette, with increasing frequency in a natural setting and in attempting to quit,” the researchers wrote. “It is not feasible to measure how smokers regulate their nicotine uptake in studies of disease risk, but the TTFC is a behavior that is strongly associated with the level of cotinine per cigarette smoked. TTFC is a distinct nicotine dependence phenotype and was also shown to be an independent risk factor for lung cancer in the current study.”