The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality

18 October 2005 | Volume 143 Issue 8 | Page 615

IN RESPONSE:

Dr. Mathew rightly points out that the Lung Health Study smoking cessation program was accompanied by the prescription of inhalers and believes that we may not have given them adequate consideration. He agrees that the content of the inhalers (placebo or bronchodilator) did not make a difference and appears to accept that it was differences in smoking habits that determined the improved survival in the special intervention group. It therefore follows that if the inhalers were important, it was because they made the smoking cessation program more effective. Maybe so, but we are unapologetic about attributing the smoking cessation largely to the program we designed to induce it. Inhalers themselves probably have little to no effect on smoking habits, as evidenced by the fact that smoking rates are about as high in persons with asthma as they are in the general population (1, 2).

Dr. Bombassei is interested in Kaplan–Meier survival curves in Lung Health Study participants who quit smoking compared with those who did not. In our paper, we indicated that mortality was 6.04 per 1000 person-years in sustained quitters, 7.77 per 1000 person-years in intermittent quitters, and 11.09 per 1000 person-years in continuing smokers. We append the appropriate Figure.

View larger version (24K): [in this window] [in a new window]   Figure. All-cause 14.5-year survival in the Lung Health Study (LHS). Four hundred eighty-five of 3322 (14.6%) patients died in the continuing smoker group versus 168 of 1607 (10.5%) in the intermittent quitter group and 78 of 958 (8.1%) in the sustained quitter group (P < 0.001 [log-rank test]).

 

Author and Article Information

Top Author & Article Info References

From University of Manitoba, Winnipeg, Manitoba R3A 1R8, Canada.

References

Top Author & Article Info References

1. Higenbottam TW, Feyeraband C, Clark TJ. Cigarette smoking in asthma. Br J Dis Chest. 1980;74:279-84. [PMID: 7426367].[Medline]

2. Silverman RA, Boudreaux ED, Woodruff PG, Clark S, Camargo CA Jr. Cigarette smoking among asthmatic adults presenting to 64 emergency departments. Chest. 2003;123:1472-9. [PMID: 12740263].[Abstract/Free Full Text]

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