Quitting Smoking – Better Late than Never

There are two research reports that demonstrate that it’s never too late to stop smoking (though it would obviously be better if quitting had occurred before the events in question).  The first report concerns the benefits of quitting smoking in early-stage lung cancer; it appears in the British Medical Journal.

A mete-analysis, based on 10 published observational studies, yielded a theoretical 5-year survival at age 65 in patients who quit after a diagnosis of primary early-stage non-small-cell or limited-stage small-cell cancers.  In both types of cancer, there was a greater chance of achieving 5-year survival than in those who continued smoking. 

For non-small cell tumors, quitters had a 70% chance, versus 33% in continuing smokers.  For limited-stage small-cell tumors, the survival rates were 63% in quitters and 29% in continuing smokers.  This study shows there is a strong case that smoking cessation can have an important role in preventing recurrence or exacerbation of lung cancers.

The second example of so-called ‘secondary prevention’ is with smoking after a heart attack (myocardial infarction, or MI).  It’s published online in the Journal of the American College of Cardiology.  This was a study of 1,500 consecutive patients aged 65 and above who were discharged from Israeli hospitals after their first heart attack.  They were followed for 10 to 13 years.

Those subjects who had never smoked had a 43% lower risk of dying than those who continued to smoke, whereas those who quit smoking after their first heart attack had a 37% lower risk of death compared to the persistent smokers. 

Only 35% of the smokers at the time of their heart attack managed to quit completely afterwards.  In the remainder, there was an 18% reduced risk of dying with each five cigarettes cut daily, i.e. cutting down is also better than nothing.

I think these two reports show conclusively that, even if you still smoke after the initial severe event (diagnosis of cancer or a heart attack), stopping ‘after the event’ brings substantial benefits, i.e. it’s not too late to quit.