Women who quit smoking significantly reduce risk of death from cardiovascular disease within five years of smoking cessation

Women who quit smoking significantly reduce risk of death from cardiovascular disease within five years of smoking cessation, according to an article in the May 7 issue of the Journal of the American Medical Association.

In addition, data analysis showed the same former smokers reduced their risk of death from smoking-related cancers by 20 percent over the same time period.

"Tobacco use remains the leading preventable cause of death in the United States. Globally, approximately 5 million premature deaths were attributable to smoking in 2000. The World Health Organization projects by 2030 that tobacco-attributable deaths will annually account for 3 million deaths in industrialized countries and 7 million in developing countries," the authors wrote. They added that the rate of mortality risk reduction after quitting compared with continuing to smoke is uncertain.

Stacey A. Kenfield, ScD, of the Harvard School of Public Health, Boston, and colleagues assessed the relationship between cigarette smoking and smoking cessation on total and cause-specific mortality in women by analyzing data from the Nurses' Health Study, an observational study of 104,519 female participants.

During follow-up from 1980 to 2004, 12,483 women died. Among them, 4,485 (35.9 percent) were never smokers, 3,602 (28.9 percent) were current smokers, and 4,396 (35.2 percent) were past smokers.

The researchers found a significant 13-percent reduction in risk of all-cause mortality within the first five years of quitting smoking compared with continuing to smoke, and the excess risk decreased to the level of a never smoker 20 years after quitting. Return to baseline risk varied for different causes.

"Significant trends were observed with increasing years since quitting for all major cause-specific outcomes. A more rapid decline in risk after quitting smoking compared with continuing to smoke was observed in the first five years for vascular diseases compared with other causes."

"Much of the reduction in the excess risk for these causes of death was realized within the first 5 years for coronary heart disease and cerebrovascular disease. Sixty-one percent of the full potential benefit of quitting in regard to coronary heart disease mortality and 42 percent of the full potential benefit of quitting in regard to cerebrovascular mortality was realized within the first 5 years of quitting smoking, when comparing hazard ratios for recent quitters of less than 5 years with long-term quitters of 20 years or greater. For death due to respiratory disease, an 18 percent reduction in risk of death was observed 5 to 10 years after quitting smoking, with the risk reaching that of a never smoker's risk after 20 years."

"Early age at initiation is associated with an increased mortality risk so implementing and maintaining school tobacco prevention programs, in addition to enforcing youth access laws, are key preventive strategies. Effectively communicating risks to smokers and helping them quit successfully should be an integral part of public health programs," the authors concluded.


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