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Carmel Reflector
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MUCH
OF THE
INCREASED
RISK OF
DEATH
FROM
SMOKING
REDUCED
WITHIN
SEVERAL
YEARS
AFTER
QUITTING
CHICAGO—Women
who quit
smoking
significantly
reduce
their
risk of
death
from
coronary
heart
disease
within 5
years
and have
about a
20
percent
lower
risk of
death
from
smoking-related
cancers
within
that
time
period,
according
to a
study in
the May
7 issue
of JAMA.
“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
write.
They add
that the
rate of
mortality
risk
reduction
after
quitting
compared
with
continuing
to smoke
is
uncertain.
Stacey
A.
Kenfield,
Sc.D.,
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,
with
follow-up
from
1980 to
2004. A
total of
12,483
deaths
occurred
in this
group,
4,485
(35.9
percent)
among
never
smokers,
3,602
(28.9
percent)
among
current
smokers,
and
4,396
(35.2
percent)
among
past
smokers.
The
researchers
found a
significant
13
percent
reduction
in the
risk of
all-cause
mortality
within
the
first 5
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,
with
some
causes
taking
more or
less
time.
“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 5
years
for
vascular
diseases
compared
with
other
causes.”
“Much of
the
reduction
in the
excess
risk for
these
causes
of death
were
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.”
For lung
cancer
mortality,
a
significant
21
percent
reduction
in risk
was
observed
within
the
first 5
years
compared
with
continuing
smokers,
but the
excess
risk did
not
disappear
for 30
years.
Past
smokers
with 20
to less
than 30
years of
cessation
had an
87
percent
reduction
in risk
of lung
cancer
mortality
compared
with
current
smokers.
When
including
the
other
smoking-related
cancers,
the
excess
risk
approached
a never
smoker’s
risk
more
than 20
years
after
quitting
smoking.
Significant
trends
were
observed
for
earlier
age at
initiation
of
smoking
for
total
mortality,
respiratory
disease
mortality,
and all
smoking-related
cancer
mortality.
The data
also
suggested
that
smoking
is
associated
with an
increased
risk of
colorectal
cancer
mortality
but not
ovarian
cancer
mortality.
The
researchers
also
found
that
approximately
64
percent
of
deaths
among
current
smokers
and 28
percent
of
deaths
among
former
smokers
were
attributable
to
cigarette
smoking.
“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
conclude.
(JAMA.
2008;299[17]:2037-2047.
Available
pre-embargo
to the
media at
www.jamamedia.org)
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