The results of a large-scale study gave hope to experienced smokers

Even short-term smoking cessation is associated with a lower risk of premature death

A new large-scale study that lasted 15 years among 1.48 million adult smokers (both active and quit) has proven the obvious and given hope to all nicotine addicts. If you quit the habit, your chances of all the terrible outcomes associated with smoking, including premature death, are reduced by as much as 90% over the years. But the best time to quit this unhealthy addiction is before the age of 40—this will prevent 90% of the lifetime mortality risk associated with smoking.

It is known that long-term cigarette smoking is one of the main causes of premature mortality throughout the world. Every year, this bad habit claims from 5 to 7 million lives of people who could live much longer if they did not smoke. This is at least a quarter of all deaths among middle-aged adults in Europe and North America.

Therefore, smoking has been actively combated throughout the world in recent years. Today, there are a significant number of adults who have quit smoking in recent decades, which makes it possible to document how much quitting a bad habit reduces modern mortality rates from various diseases associated with smoking. Smokers considering quitting are, of course, interested in understanding not only the lifetime risk reduction, but also the extent and rate at which quitting reduces the risk of short-term mortality and many diseases.

The NEJM journal Evidence published the results of a large-scale meta-analysis of studies from four national cohorts in the US, UK, Norway and Canada. For 15 years, the researchers followed 1.48 million adults, among whom 122,697 died during this time. The researchers quantified the potential benefits of quitting smoking by age, sex, and years since quitting on cause-specific mortality. They pooled risk ratios for current or former smokers versus never smokers according to age and quitting less than 3, 3 to 9, or 10 or more years ago.

As the authors note, after adjusting for age, education, alcohol consumption and obesity, current smokers had higher risk ratios for death compared with never smokers (2.8 for women, 2.7 for men). Former smokers had a lower risk ratio (1.3 for both women and men). Survival from ages 40 to 79 years was 12 and 13 years shorter for women and men who smoked, respectively, compared with never smokers (about 24–26 years of life lost for smokers who died from smoking, combined with zero losses for smokers who smoked).

In addition, short-term smoking cessation of less than 3 years was associated with a lower excess risk of premature death by 95% in women and 90% in men under 40 years of age. Moreover, noticeable positive associations were also observed in women and men aged 40 to 49 years (81% and 61%, respectively) and from 50 to 59 years (63% and 54%, respectively). Quitting smoking at any age was associated with longer survival, especially stopping before age 40. Across all ages and compared with continued smoking, quitting for less than 3 years potentially averted 5 years of life lost, and quitting for 10 or more years averted about 10 years of life lost, providing survival similar (!) to never smokers.

The main conclusions of the scientists: quitting smoking at any age, but especially in young years, is associated with a lower mortality rate in general, as well as from vascular, respiratory and cancer diseases. Quitting smoking at any age was associated with longer survival, with benefits becoming apparent as early as three years after quitting.

According to Corresponding Member of the Russian Academy of Sciences, Professor David Zaridze, quitting smoking is the most effective way to reduce morbidity and mortality. At the same time, in our country the decline in the prevalence of smoking is proceeding at an extremely slow pace, and in recent years it has hardly moved from a standstill. For example, the smoking rate among Russian women, which has gradually decreased since 2009, has increased again and returned to the 2009 level, i.e. to 21% – this is data from VTsIOM. “These figures are confirmed by the increase in the incidence of lung cancer: since 2012, the incidence among women began to increase for the first time since 1993 and by 2018 increased by 29%,” says Professor Zaridze.

From 2009 to 2016, the number of Russian men who smoke decreased to 47%, but has remained stagnant since then. Many experts believe that the practice of bans (on smoking in public places, etc.) has simply stopped working – and it’s time for the state to look for new strategies that will reduce smoking rates.