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Stopping smoking is beneficial and has a dramatic effect.The British doctors study, using 50-year follow-up data, compared the survival of cigarette smokers who stopped with that of those who continued to smoke. Those who stopped before 35 years of age had a survival curve that did not differ significantly from that of never-smokers.
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The effect of stopping, can best be seen by looking at a particular age. Thus, for example, at age 70, just under 60% of current smokers in the study were still alive, compared with about 80% of those who had stopped smoking by 45 years.This is not a small difference. Even at age 90 years the difference is still marked. Only ~5% of smokers are still alive compared with ~25% of those who had stopped by age 35, almost five times as many.
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For those who stopped later, this study showed that survival was intermediate between that of never-smokers and that of continuing smokers. But even those who stopped at 65-74 years of age had age-specific mortality rates beyond 75 years that were appreciably lower than those occurring among doctors who continued to smoke. Furthermore, the benefit of stopping in late middle age or old age is probably underestimated in these analyses, as some of those who stopped in later life are likely to have done so specifically because they had already developed serious diseases caused by smoking. Thus, if they were taken out of the analysis, the survival rates for healthier smokers stopping at that age would likely be better.
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Stopping smoking in middle age before developing cancer or some other serious disease avoids most of the later excess risk of death from tobacco use. On the basis of this work Peto and colleagues have argued that if the goal is to reduce smoking-related disease in a population as quickly as possible, the most rapid results will be obtained by focusing on reducing the proportion of adults who continue to smoke, because this will alter patterns of disease within ~20-25 years. Encouraging and supporting adults to quit will itself help to deter children from taking up smoking.
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As with the mortality data, it is possible to see that stopping smoking delays the onset of disease and disability; these data also show that stopping even in later life brings benefits.
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The following findings are drawn from the 1990 US Surgeon General’s report on the benefits of stopping.
This concluded that the risk of serious disease starts going down immediately on quitting :
- in 20 hours carbon monoxide is eliminated from the body;
- in 3 days breathing becomes easier, the bronchial tubes begin to relax;
- in 3 months circulation improves;
- in 3-9 months lung function improves by ~10%;
- in 1 year the risk of heart attack falls to about half that of a continuing smoker;
- long-term stopping smoking reduces the risk of lung cancer, heart disease, strokes, chronic lung disease and other cancers.
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Indeed Lightwood and Glantz found rapid improvements in heart disease and stroke from cessation of smoking; the excess risk of an acute myocardial infarction or stroke falls by ~50% within the first 2 years of stopping smoking. They estimated that a national programme reducing the prevalence of smoking by 1% per year in the USA would, in 1 year, result in a mean of over 900 fewer hospitalisations for acute myocardial infarction and over 500 for stroke, resulting in immediate savings of between $26 and 44 million.
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Even those who have survived an acute myocardial infarction benefit from stopping smoking, which can diminish their risk of a recurrent event by up to half over the first year. In summary, stopping smoking has substantial immediate and long-term benefits to health for smokers of all ages.The excess risk of death from smoking falls soon after cessation and continues to do so for many years.
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Of course, stopping smoking or indeed use of other forms of tobacco can be difficult, largely because of dependence on nicotine.
