If you’re a smoker older than 35, don’t despair — the findings, published on October 24 in JAMA Network Open, reported significant benefits for quitting later in life, too. “If current smokers younger than 45 years old quit (the age group that smokes the most), they will reduce their risk of dying from any cause close to that of someone who never has smoked,” says Adam Goldstein, MD, MPH, a professor at UNC Family Medicine and the director of the tobacco intervention programs at the University of North Carolina School of Medicine in Chapel Hill, who was not involved in the research. “Even those who quit by age 65 will cut their risk of dying by two-thirds compared to those who continue to smoke,” says Dr. Goldstein.
About 30 Million Americans Currently Smoke Cigarettes
In 2020, about 12.5 percent, or 30.8 million, U.S. adults reported smoking cigarettes, down from 20.9 percent in 2005. Even with that improvement, smoking is still the leading cause of preventable disease and death in the United States, according to the Centers for Disease Control and Prevention (CDC). It’s estimated that cigarettes kill about 480,000 Americans each year. Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. It also increases the risk of tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis, per the CDC.
Majority of Smokers Will Die From a Smoking-Related Illness
Researchers used nationally representative data from the U.S. National Health Interview Survey, which was collected via questionnaires between January 1997 and December 2018. The 551,388 participants were between ages 25 and 84 at the time of recruitment, with an average age of 49 years old. Of the participants, 19.8 percent said they were current smokers, 55.9 percent reported never smoking, and 24.3 percent were former smokers. People enrolled in the study were followed for as long as 17 years, and the average follow-up was 11 years; during that time, 74,870 people died. Investigators found that among people who were current or former smokers, an estimated 44 percent of the deaths were linked with smoking: 52.2 percent of cancer deaths, 34.7 percent of heart disease deaths, and 86.9 percent of deaths from lower respiratory disease were attributed to smoking. The findings from this large study confirm what has been previously shown — that smoking causes tremendous excess death across men and women, and among white, Black, and Hispanic patients, says Goldstein. “Cigarette smoking, and its promulgation by tobacco companies, are equal-opportunity killers. For current smokers, a majority will die of or suffer from a smoking-related illness,” he says.
White Current Smokers Had the Highest Additional Risk of Early Death Compared With Other Races or Ethnicities
Because of the large number of people in the study, researchers were able to examine smoking behavior and risk in different groups. After adjusting for age, education level, and alcohol consumption, current smokers who were white had the highest excess mortality — three times that of never smokers. For Black and Hispanic current smokers, the excess risk was 2.19 and 2.01 times, respectively. The higher excess mortality found in white current smokers may be related to the fact that they reported starting smoking at an earlier age and were more likely to smoke daily and smoke more cigarettes per day than Black and Hispanic smokers, wrote the authors.
Findings Support the Importance and Benefits of Smoking Cessation
Smokers who quit after age 35 did have a higher risk of early death than never smokers, but they were still able to substantially reverse their risk, according to the authors. Quitting smoking before age 45 was associated with an estimated 90 percent reduction of the added mortality risk associated with continued smoking, and quitting between ages 45 and 64 was associated with a reduction of approximately 66 percent of the excess risk. That’s good news, says Goldstein. “It is never too late to quit smoking, and the earlier you quit, the greater the benefit, and that’s true for everyone. Smoking cessation is the best thing most people in the U.S. can do to prolong their life irrespective of racial, gender, or ethnic group,” he says. The authors also found that the more time had passed since a person stopped smoking, the closer their mortality rate was to that of someone who had never smoked.
Resources to Help You Quit Smoking
Tobacco addiction is both mental and physical, according to the American Cancer Society. Often the best path to successfully quitting is a combination of medicine, a plan to change personal habits, and emotional support. Smokefree.gov provides tools and tips, including supportive text messages, help building a quit plan, and a guide to using nicotine replacement therapy. The app quitSTART takes the information you provide about your smoking history to provide personalized tips, inspiration, and challenges to help you stop smoking for good.
