It Is Never Too Late to Quit Smoking

Smoking increases the risk for heart disease and heart-related death.  Quitting smoking is known to reduce these risks.  However, the impact of quitting smoking on older adults has not been well-studied.  Does quitting smoking after the age of 60 make a difference? 

The answer is yes.  A study looked at over 500,000 smokers and nonsmokers aged 60 and older, to evaluate the impact of smoking and quitting smoking on heart-related outcomes specifically in this age group.  The 3 major heart-related outcomes were evaluated:  (1) cardiovascular deaths, (2) acute coronary events (defined as heart attack, unstable angina, or coronary death), and (3) stroke.

 

Impact of smoking and quitting on cardiovascular health events

The study found that current smokers are at increased risk of all 3 of these outcomes compared to former smokers and those who have never smoked.  In the current smoker group, the risk increased based on the number of cigarettes per day a person smoked.  In former smokers, the risk of the 3 outcomes decreased with the time since quitting.  Improvement was seen within 5 years of quitting and showed continual improvement the longer the time that the person had quit smoking.  In persons who had quit 20 or more years ago, the risk was only slightly higher. 

 

How many years of life do smokers lose? 

The researchers also evaluated the impact of smoking on advancing the risk of dying.  Smoking advanced the risk of dying from cardiovascular disease by 5.5 years.  This increased to almost 7 years in persons who smoked 20 or more cigarettes per day.  The advanced risk of dying was 2.6 years in former smokers.  Within 5 years of quitting, smokers gain back almost 1 year, and the longer the time since the last cigarette, the more time the person gains back.  

Thus, smoking matters, even in persons who are 60 years or older.  It has harmful effects on heart health and cuts off years of one’s life.  Importantly, this study supports that quitting smoking—even in older adults—reduces the excess risk of cardiovascular events caused by smoking.  In other words, it is never too late to quit smoking.

 

Products to help people quit smoking:  2 may be better than one 

The US Preventive Services Task Force is a nationally appointment expert group that provides recommendations for health care professionals. In September 2015, it updated its Recommendations on Interventions for Smoking Cessation.  Using two types of nicotine replacement products has better results for quitting compared to using just one type.  This means that using a nicotine patch and nicotine gum or lozenges can be more helpful than using just one of these products.  Similarly, adding a nicotine replacement product to bupropion therapy is beneficial, as well.  Use of electronic cigarettes as a tool to help quit smoking is not recommended at this time due to insufficient information on these products.

For information on smoking cessation products and behavioral strategies, contact HbL PharmaConsulting. 

References: 

Mons U, et al. Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults: meta-analysis of individual participant data from prospective cohort studies of the CHANCES consortium.  BMJ 2015;350:h1551. Doi:10.1136/bmj.h1551.

Siu AL. Behavioral and pharmacotherapy interventions for tobacco smoking cessation in adults, including pregnant women: US Preventive Services Task Force recommendation statement. Ann Intern Med 2015;163:622.

Patnode CD et al. Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: A review of reviews for the US Preventive Services Task Force. Ann Intern Med 2015;163:608.

 This material is informational only and not intended to replace the guidance of your health care team.