I'll quit smoking when it hurts me

Probably one of the most repeated statements from smokers when advised to quit smoking is: "I will quit the day I start feeling its effects". Big mistake. This is just a defensive mechanism humans use to avoid the truth: I am addicted and just the idea of going through the pain of quiting is overwhelming.

The mistake is to believe that the day we quit smoking we recover from its ill effects right away. Recovery does start inmediately, but it is very slow. And whatever harm has already been made is mostly for good. Particularly in terms of risk for cancer, COPD, and  cardiovascular diseases. For example, the first warning sign of the negative effects of tobacco may be a fatal heart attack or pain from metastases of a lung cancer. Quitting then is too late.

A very interesting study published in The Lancet (*) in October 2012, clearly shows that the sooner one quits the greater the benefits. And these benefits do not refer to breathing better or having less cough, which also occur. The main benefit is a much longer life.

Between 1996 and 2001, 1,300,000 women of 50 to 69 years of age participating in UK's National Early Breast Cancer Detection Program were selected for the study. They all completed a questionnaire with information  related to their smoking history and their past medical history. Three and eight years afterwards they again completed similar questionnaires. The main goal of the study was to determine the effect of tobacco smoking on mortality.

According to their smoking status, the entire group of participants were classified into 3 groups:

• Active smokers               20%
• Former smokers              28%
• Never smokers                52%

Results of the study are quite striking:

• In the 12 years that theses women were followed, the number of participants who died among smokers was 3-fold greater than among never smokers. And this is true even after the fact that almost half (44%) of the smokers had quit smoking at the time of the questionnaire done at 8 years after the start of the study.

• Even among women who smoked less than 10 cigarrettes a day, the number of deaths was 2-fold greater than in never smokers.

These results can be summarized more graphically with the following bullets (no pun intended):

•  53% of smokers and 22% of never smokers die before the age of 80.

• Two out of every three deaths in women below the age of 80 are tobacco related.

• Women who never smoked lived and average of 11 years longer.

I think it would be helpful to stop here for a moment to think about these statistics. They confirm what was already suspected from many epidemiologic studies: the benefits of quitting the habit occur mostly many years later. In the study we are analyzing, women who quit before the age of 40 avoid 90% of the premature tobacco related deaths. In conclussion, althouhg it is never too late to quit, the sooner the better.

* Kirstin Pirie, Richard Peto, Gillian K Reeves, Jane Green, Valerie Beral, for the Million Women Study Collaborators The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK.

www.thelancet.com Published online October 27, 2012 http://dx.doi.org/10.1016/S0140-6736(12)61720-6