A new report from Norway, published in Annals of Internal Medicine, presents stark new data on the lethal effects of cigarettes. The Norwegian scientists accumulated smoking and mortality data from almost 50,000 people over the course of twenty-five years -- the largest study ever to include women, who comprised half of the study subjects. The subjects were in the forty- to seventy-year age range.
The results are chilling, although not surprising: while women who never smoked had a death rate of 9% during the quarter-century-long follow-up, those who continued to smoke over twenty cigarettes daily had a mortality rate of 26%! The male smokers had an even worse outcome: their death rate was an astounding 41%, compared to 14% among the never-smokers. (The difference in death toll between men and women resulted from the men's higher rate of cardiovascular death, in both smokers and non-smokers.)
These data are scary enough, but other facts in the authors' discussion are even worse, in some ways: they detail the toll of cigarettes worldwide. Smoking is now the major preventable cause of death in adults around the world, accounting for about 5 million dead, an amazing 8.8% of all deaths, according to the World Health Organization. Further, more than half of the smoking-attributable deaths occur in middle age, thirty to sixty-nine years -- 13% of all deaths in this age range. Even worse still, the use and thus the toll of smoking is increasing in the less-developed areas of the world.
Smoking affects every body system and organ. While cancer and heart disease are its primary death-dealers, many other ailments, from the lethal to the merely unpleasant, are also promoted by cigarettes.
Other results of this study support the long-held belief, based on other reliable data (especially the British Doctors Study by Doll and Peto, a fifty-year follow-up to which was published in 2004), that quitting reduces the mortality risk at all ages, in both sexes. Of course, quitting at earlier ages led to the most years of life gained -- but even quitting after age fifty resulted in some reduction in the risk of death by smoking. It's never too late to quit! Unfortunately, many doctors don't even bother to bring up the subject with smoking patients, even though merely inquiring about smoking and discussing cessation methods with patients is shown to be a common first step on the road to quitting.
Since the longer one smokes, and the younger the age at which smoking is begun, the more damage is done, we must redouble our efforts to keep young people -- especially in Asia, Africa, and Latin America -- from taking up this deadly habit. Here in the U.S., recent statistics have revealed some progress on this front, as the smoking rate among teens is declining. But as the above mortality data once again confirm, this is no time to relax.
Gilbert L. Ross, M.D., is Executive and Medical Director of the American Council on Science and Health (ACSH.org, HealthFactsAndFears.com).
