Never Too Late To Quit Smoking: CVD Mortality Reduced When Patients Quit After Age 60

April 24, 2015

HEIDELBERG, GERMANY — Good news for older adults who decide to quit smoking—even after 60 years of age, quitting smoking for 5 years translates into a significant reduction in cardiovascular mortality when compared with individuals who continued to smoke[1].

The results, from a new meta-analysis of 503,905 participants aged 60 years of age and older, showed that 5 years after quitting smoking, these older individuals had a 10% lower risk of cardiovascular mortality compared with continuing smokers. Similarly, those who quit for 5 to 9 years and for 10 to 19 years had a 16% and 22% lower risk of cardiovascular death, respectively.

"Even though the risk avoided by smoking cessation is greater the earlier a smoker quits, our data show that smoking cessation was still associated with a substantial reduction of cardiovascular risks even in the oldest age groups," according to Dr Ute Mons (German Cancer Research Center, Heidelberg, Germany) and colleagues.

Published April 22, 2015 in the BMJ, the researchers also confirmed that in this older cohort, smoking was associated with a twofold increased risk of cardiovascular mortality compared with nonsmokers. For those who smoked previously but had currently quit, the risk of cardiovascular mortality was only 37% higher compared with nonsmokers. Regarding the risk of acute coronary events, current smokers and former smokers had a significant 98% and 18% higher risk of events when compared with nonsmokers.

The study included participants in cohorts enrolled in the CHANCES consortium, a collaborative project conducted in Europe and North America. In total, 25 cohorts were included in the meta-analysis. The mean follow-up period ranged from 8 to 13 years, during which time there were 37,952 cardiovascular deaths.

As part of their analysis, the researchers also estimated the "risk-advancement" period for cardiovascular mortality from smoking. For current smokers, the risk-advancement period was 5.5 years, meaning smokers died from cardiovascular causes an average of 5.5 years earlier than those who did not smoke. For former smokers, the risk-advancement period was 2.16 years. Individuals who smoked 20 or more cigarettes per day had the highest risk of cardiovascular mortality (hazard ratio 2.63; 95% CI 2.28–3.04) compared with nonsmokers and the highest risk-advancement estimate at 6.90 years.

"Even though comparably high quit success rates can be achieved, studies suggest that older smokers are less likely to receive smoking-cessation support than younger smokers," write Mons and colleagues. "Hence, our findings on the hazards of smoking and the benefits of quitting in older ages have important public-health implications."

Unless smoking-cessation efforts are intensified in this older population, however, the "tremendous potential for cardiovascular disease prevention will remain largely untapped," state the researchers.

The authors report they have no relevant financial relationships.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.