The hazards of smokingand the benefits of stopping

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The hazards of smokingand the benefits of stopping

• Particular emphasis is given to the risk of deathin middle age (defined as ages 35-69)

• Available on www.other-mother.in

• This presentation provides evidence from the UK and the USA, where the health effects of smoking have been studied over a long period, but these findings apply tomany other countries

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Main messages for the individual smoker

– Even in early middle age, those who stop (before they have lung cancer or some other fatal disease) avoid most of their risk of being killed by tobacco

• Those killed in middle age lose many years

• Stopping smoking works

– Stopping before middle age works even better

• The risk is big: about half are killed

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Stopping smoking: avoiding lung cancer

% dead fromlung cancer

Continued smoking: 16% dead from lung cancer

Stopped age 50: 6%

Stopped age 30: 2%

Never smoked: <1%

15

10

5

0

45 55 65 75Age

Cumulative risk at UK male 1990 ratesBMJ 2000; 321: 323-9 Brought to you by

Delay between cause and effect:cigarettes, then lung cancer deaths

Cigarettes per adult per day

10

5

0

1900 1920 1940 1960 1980 2000USA:

lung cancer

lung cancer

cigarette consumption+

Lung cancer deaths per million per year

0

500

1,000

Long-term study of persistent smoking

• They were studied for 50 years by Richard Doll

• Source: “Mortality in relation to smoking:50 years’ observations on male British doctors”Doll R, Peto R et al. BMJ 2004; 328: 1519-28

• UK men born in the 20th century: first population in theworld exposed to really prolonged cigarette smoking

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Study of smoking and death in male British doctors

• Recorded all deaths for 50 years (1951-2001)

• Main findings (for men born in the 20th century)– Smokers lose, on average, 10 years of healthy life

• Asked all UK doctors in 1951, and periodically thereafter, what they themselves smoked

– Stopping smoking worksBrought to you by

Survival to age 70 and beyond:effect of smoking in male British doctors

0

20

40

60

80

100

% survivalfrom age 35

40 50 60 70 80 90 100Age

97

94

91

81

59

26

24

42

10years

10years

58%Cigarettesmokers

Non-smokers81%

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Effect of stopping smoking at about age 40

% survivalfrom age 40

0

20

40

60

80

100

40 50 60 70 80 90 100

Age

Non-smokers

Cigarettesmokers

and gained about 9 yearsEx-smokers stopped at 35-44

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Decrease in smoking prevalence

• In 1950, about 80% of UK men smoked

United Kingdom, 1950-2002

1950 1960 1970 1980 1990 2000

0

20

40

60

80

%at ages35-59

70%

50%

28%

26%

% smoked

% smoked

• In 1970, UK male death rates from smoking were the worst in the world

• 1970-2000, decrease in male death rates from smoking was the best in the world

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Looking back to 1970 death rates:of 100 men aged 35 …

United Kingdom, 1970

*risks at year 1970death rates for ages 35-69

• 42 would have died in middle age*

42%

• 20 of these 42 deaths would have been from smoking

20

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Male death in middle age: changing hazards*

United Kingdom, 1950-2000

*risks at period-specificdeath rates for ages 35-69

1950

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

44%

43%

42%

43%

42%

39%

37%

35%

31%

28%

25%

All causes15

18

19

20

20

17

16

14

11

8

6

Smoking

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Male death in middle age: changing hazards*

Poland, 1955-2000

*risks at period-specificdeath rates for ages 35-69

1955

1960

1965

1970

1975

1980

1985

1990

1995

2000

44%

All causes

40%

39%

41%

41%

46%

46%

47%

45%

41%

6

8

9

12

13

16

19

20

19

16

Smoking

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Main messages for the individual smoker

• Those killed in middle age may well lose10, 20, 30 or more good years

• Stopping smoking works

• The risk is big: about half are killed

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Richard Doll (1912-2005), who stopped smoking cigarettes at age 37,photographed aged 91 at the 2004 BMJ press conferenceon the 50-year results from his study of British doctors

Michael Crabtree, copyright Troika PhotosBrought to you by

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