 |
 |
|
Home |
Current Issue |
Past Issues |
In the Clinic |
ACP Journal Club |
CME |
Collections |
Audio/Video |
Mobile |
Subscribe |
Tools |
Help |
ACP Online
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 November 1993 | Volume 119 Issue 10 | Pages 992-1000
Objective: To examine the temporal relationship between stopping smoking and total mortality rates among middle-aged women.
Design: Prospective cohort study with 12 years of follow-up.
Setting: Registered nurses residing in the United States.
Participants: 117 001 female registered nurses, ages 30 to 55 years, who were free of manifest coronary heart disease, stroke, and cancer (except nonmelanoma skin cancer) in 1976.
Main Outcome Measures: Total mortality, further categorized into deaths from cardiovascular diseases, cancers, and violent deaths.
Results: A total of 2847 deaths (933 among "never smokers," 799 among former smokers, and 1115 among current smokers) occurred during 1.37 million person-years of follow-up. The multivariate relative risks for total mortality compared with never smokers were 1.87 (95% CI, 1.65 to 2.13) for current smokers and 1.29 (CI, 1.14 to 1.46) former smokers. Participants who started smoking before the age of 15 years had the highest risks for total mortality (multivariate relative risk, 3.15; CI, 2.16 to 4.59), cardiovascular disease mortality (relative risk, 9.94; CI, 5.15 to 19.19), and deaths from external causes of injury (relative risk, 5.39; CI, 1.84 to 15.78). Compared with continuing smokers, former smokers had a 24% reduction in risk for cardiovascular disease mortality within 2 years of quitting. The excess risks for total mortality and both cardiovascular disease and total cancer mortality among former smokers approached the level of that for never smokers after 10 to 14 years of abstinence. The health benefits of cessation were clearly present regardless of the age at starting and daily number of cigarettes smoked.
Conclusions: The risk of cigarette smoking on total mortality among former smokers decreases nearly to that of never smokers 10 to 14 years after cessation.
Author and Article Information
From Harvard Medical School, Brigham and Women's Hospital, and Harvard School of Public Health, Boston, Massachusetts.
ARTICLE
Smoking Cessation in Relation to Total Mortality Rates in Women: A Prospective Cohort Study
Request for Reprints: Ichiro Kawachi, MB ChB, Channing Laboratory, 180 Longwood Avenue, Boston, MA 02115-5899.
Acknowledgments: The authors thank the participants in the Nurses' Health Study and Mark Shneyder, Karen Corsano, Gary Chase, Barbara Egan, and Lisa Dunn for data collection and management.
Grant Support: By research grants HL 34594 and CA 40356 from the National Institutes of Health. Dr. Kawachi is the recipient of an Overseas Research Fellowship of the Health Research Council of New Zealand. Dr. Colditz is supported by a Faculty Research Award (FRA 398) from the American Cancer Society.
This article has been cited by other articles:
|
|
 |
|
  G. A. Colditz and D. M. Winn Criteria for the Evaluation of Large Cohort Studies: An Application to the Nurses' Health Study J Natl Cancer Inst, July 2, 2008; 100(13): 918 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. A. Kenfield, M. J. Stampfer, B. A. Rosner, and G. A. Colditz Smoking and Smoking Cessation in Relation to Mortality in Women JAMA, May 7, 2008; 299(17): 2037 - 2047. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T Streppel, H. C Boshuizen, M. C Ocke, F. J Kok, and D. Kromhout Mortality and life expectancy in relation to long-term cigarette, cigar and pipe smoking: The Zutphen Study Tob. Control, April 1, 2007; 16(2): 107 - 113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. P. Derdeyn Carotid Stenting for Asymptomatic Carotid Stenosis: Trial It Stroke, February 1, 2007; 38(2): 715 - 720. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. James, M. G. Jamison, M. S. Biswas, L. R. Brancazio, G. K. Swamy, and E. R. Myers Acute Myocardial Infarction in Pregnancy: A United States Population-Based Study Circulation, March 28, 2006; 113(12): 1564 - 1571. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Vollset, A. Tverdal, and H. K. Gjessing Smoking and deaths between 40 and 70 years of age in women and men. Ann Intern Med, March 21, 2006; 144(6): 381 - 389. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Prepared by: British Cardiac Society, British Hype JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice Heart, December 1, 2005; 91(suppl_5): v1 - v52. [Full Text] [PDF]
|
|
|
|
|
|
S. A. Schroeder What to Do With a Patient Who Smokes JAMA, July 27, 2005; 294(4): 482 - 487. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C P Wen, S P Tsai, T Y Cheng, H T Chan, W S I Chung, and C J Chen Excess injury mortality among smokers: a neglected tobacco hazard Tob. Control, June 1, 2005; 14(suppl_1): i28 - i32. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Iso, C. Date, A. Yamamoto, H. Toyoshima, Y. Watanabe, S. Kikuchi, A. Koizumi, Y. Wada, T. Kondo, Y. Inaba, et al. Smoking Cessation and Mortality from Cardiovascular Disease among Japanese Men and Women: The JACC Study Am. J. Epidemiol., January 15, 2005; 161(2): 170 - 179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. T. B. Knoops, L. C. P. G. M. de Groot, D. Kromhout, A.-E. Perrin, O. Moreiras-Varela, A. Menotti, and W. A. van Staveren Mediterranean Diet, Lifestyle Factors, and 10-Year Mortality in Elderly European Men and Women: The HALE Project JAMA, September 22, 2004; 292(12): 1433 - 1439. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Tsiara, M. Elisaf, and D. P. Mikhailidis Influence of Smoking on Predictors of Vascular Disease Angiology, September 1, 2003; 54(5): 507 - 530. [Abstract] [PDF]
|
|
|
|
|
|
N. S. Godtfredsen, C. Holst, E. Prescott, J. Vestbo, and M. Osler Smoking Reduction, Smoking Cessation, and Mortality: A 16-year Follow-up of 19,732 Men and Women from the Copenhagen Centre for Prospective Population Studies Am. J. Epidemiol., December 1, 2002; 156(11): 994 - 1001. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Haveman-Nies, L. P. G. M. de Groot, J. Burema, J. A. A. Cruz, M. Osler, and W. A. van Staveren Dietary Quality and Lifestyle Factors in Relation to 10-Year Mortality in Older Europeans: The SENECA Study Am. J. Epidemiol., November 15, 2002; 156(10): 962 - 968. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Q. Lan, R. S. Chapman, D. M. Schreinemachers, L. Tian, and X. He Household Stove Improvement and Risk of Lung Cancer in Xuanwei, China J Natl Cancer Inst, June 5, 2002; 94(11): 826 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The United Kingdom Small Aneurysm Trial Participan Long-Term Outcomes of Immediate Repair Compared with Surveillance of Small Abdominal Aortic Aneurysms N. Engl. J. Med., May 9, 2002; 346(19): 1445 - 1452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. E Roeters van Lennep, H.T. Westerveld, D.W. Erkelens, and E. E van der Wall Risk factors for coronary heart disease: implications of gender Cardiovasc Res, February 15, 2002; 53(3): 538 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Bolego, A. Poli, and R. Paoletti Smoking and gender Cardiovasc Res, February 15, 2002; 53(3): 568 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. K. Al-Delaimy, J. E. Manson, C. G. Solomon, I. Kawachi, M. J. Stampfer, W. C. Willett, and F. B. Hu Smoking and Risk of Coronary Heart Disease Among Women With Type 2 Diabetes Mellitus Arch Intern Med, February 11, 2002; 162(3): 273 - 279. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. K. Al-Delaimy, W. C. Willett, J. E. Manson, F. E. Speizer, and F. B. Hu Smoking and Mortality Among Women With Type 2 Diabetes: The Nurses' Health Study cohort Diabetes Care, December 1, 2001; 24(12): 2043 - 2048. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Pelkonen, I-L Notkola, H Tukiainen, M Tervahauta, J Tuomilehto, and A Nissinen Smoking cessation, decline in pulmonary function and total mortality: a 30 year follow up study among the Finnish cohorts of the Seven Countries Study Thorax, September 1, 2001; 56(9): 703 - 707. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q Qiao, M Tervahauta, A Nissinen, and J Tuomilehto Mortality from all causes and from coronary heart disease related to smoking and changes in smoking during a 35-year follow-up of middle-aged Finnish men Eur. Heart J., October 1, 2000; 21(19): 1621 - 1626. [Abstract] [PDF]
|
|
|
|
|
|
M. Pelkonen, H. Tukiainen, M. Tervahauta, I.-L. Notkola, S.-L. Kivelä, Y. Salorinne, and A. Nissinen Pulmonary function, smoking cessation and 30 year mortality in middle aged Finnish men Thorax, September 1, 2000; 55(9): 746 - 750. [Abstract] [Full Text]
|
|
|
|
|
|
G. J. Hankey, K. Jamrozik, R. J. Broadhurst, S. Forbes, P. W. Burvill, C. S. Anderson, and E. G. Stewart-Wynne Five-Year Survival After First-Ever Stroke and Related Prognostic Factors in the Perth Community Stroke Study Stroke, September 1, 2000; 31(9): 2080 - 2086. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. A. Rigotti A 36-Year-Old Woman Who Smokes Cigarettes JAMA, August 9, 2000; 284(6): 741 - 749. [Full Text] [PDF]
|
|
|
|
|
|
M. J. Stampfer, F. B. Hu, J. E. Manson, E. B. Rimm, and W. C. Willett Primary Prevention of Coronary Heart Disease in Women through Diet and Lifestyle N. Engl. J. Med., July 6, 2000; 343(1): 16 - 22. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R. Jacobs Jr, H. Adachi, I. Mulder, D. Kromhout, A. Menotti, A. Nissinen, H. Blackburn, and for the Seven Countries Study Group Cigarette Smoking and Mortality Risk: Twenty-five-Year Follow-up of the Seven Countries Study Arch Intern Med, April 12, 1999; 159(7): 733 - 740. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. Kawachi, G. A. Colditz, F. E. Speizer, J. E. Manson, M. J. Stampfer, W. C. Willett, and C. H. Hennekens A Prospective Study of Passive Smoking and Coronary Heart Disease Circulation, May 20, 1997; 95(10): 2374 - 2379. [Abstract] [Full Text]
|
|
|
|
|
|
Mortality After 16 Years for Participants Randomized to the Multiple Risk Factor Intervention Trial Circulation, September 1, 1996; 94(5): 946 - 951. [Abstract] [Full Text]
|
|
Article
