the hazards of smoking and the benefits of stopping
TRANSCRIPT
The hazards of smokingand the benefits of stopping
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.deathsfromsmoking.net
• 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
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
www.deathsfromsmoking.net
• 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
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
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
www.deathsfromsmoking.net
• UK men born in the 20th century: first population in theworld exposed to really prolonged cigarette smoking
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
www.deathsfromsmoking.net
• Asked all UK doctors in 1951, and periodically thereafter, what they themselves smoked
– Stopping smoking works
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%
Effect of stopping smoking at about age 40
% survivalfrom age 40
0
20
40
60
80
100
40 50 60 70 80 90 100Age
Non-smokers
Cigarettesmokers
and gained about 9 yearsEx-smokers stopped at 35-44
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
Looking back to 1970 death rates:of 100 men aged 35 …
www.deathsfromsmoking.net
United Kingdom, 1970
www.deathsfromsmoking.net
*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
Male death in middle age: changing hazards*
www.deathsfromsmoking.net
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
Male death in middle age: changing hazards*
www.deathsfromsmoking.net
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
Main messages for the individual smoker
• Those killed in middle age may well lose10, 20, 30 or more good years
• Stopping smoking works
www.deathsfromsmoking.net
• The risk is big: about half are killed
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 Photos
Deaths from smoking: an electronic resource
www.deathsfromsmoking.net
Published byInternational Union Against Cancer (UICC), Geneva: Switzerland, 2006
Funded byClinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of OxfordInternational Union Against Cancer (UICC)Fogarty International Center, US NIHUK Medical Research CouncilCancer Research UK
Project team Richard Peto, Judith Watt, Jillian BorehamProject management Sinéad JonesAdvice and support Steve Woodward, Konrad Jamrozik, Lesley Walker, Trish CotterDesign bwa-design.co.uk