New evidence supports an old conclusion:  If you’ve never smoked, don’t start.  If you do smoke, stop.  Two articles published in this week’s New England Journal of Medicine point to the fact that cigarette smoking remains a huge public health problem.

Prabhat Jha, M.D. et al looked at the data of more than 200,000 Americans from 1997-2004 and showed a death rate (from any cause) in smokers that was three times higher than in those who never smoked:

Most of the excess mortality among smokers was due to neoplastic, vascular, respiratory, and other diseases that can be caused by smoking. The probability of surviving from 25 to 79 years of age was about twice as great in those who had never smoked as in current smokers (70% vs. 38% among women and 61% vs. 26% among men). Life expectancy was shortened by more than 10 years among the current smokers, as compared with those who had never smoked. Adults who had quit smoking at 25 to 34, 35 to 44, or 45 to 54 years of age gained about 10, 9, and 6 years of life, respectively, as compared with those who continued to smoke.


For smokers, their families and friends, and strangers caught in the second-hand toxins, the news is good:  it’s never too late to stop smoking.

The second study, by Michael J. Thun, M.D. et al shows in a 50-year statistical analysis that, when it comes to the risk of dying from smoking, women have caught up to men:

First, the relative and absolute risks of death from smoking continue to increase among female smokers; the relative risks of death from lung cancer, COPD, ischemic heart disease, any type of stroke, and all causes are now nearly identical for female and male smokers. This finding is new and confirms the prediction that, in relative terms, “women who smoke like men die like men.”


Finally, Steven A. Schroeder, M.D. finishes with an editorial in the NEJM that summarizes these two studies before offering his opinion:

Two important messages emerge from these articles. First, in terms of health benefits, it is never too late to quit. Clinicians in general, and especially those who care for patients with smoking-related illnesses (e.g., oncologists, cardiologists, pulmonologists, emergency physicians, psychiatrists, and primary care physicians), should do more to stimulate quit attempts. Second, the importance of smoking as a health hazard needs to be elevated. More women die of lung cancer than of breast cancer. But there is no “race for the cure” for lung cancer, no brown ribbon, and no group analogous to the Susan G. Komen Breast Cancer Foundation. Because smoking has become a stigmatized behavior concentrated among persons of low social status, it risks becoming invisible to those who set health policies and research priorities. Yet, the need for greater attention to the policies known to reduce the prevalence of smoking remains urgent. As former Australian Health Minister Nicola Roxon has said, “We are killing people by not acting.”


More on smoking on The PediaBlog here.