Smoking cessation in old age: Less heart attacks and strokes within 5 years
Professor Hermann Brenner and colleagues analyzed the data of 8.807 individuals aged between 50 and 74 years using data of Saarland citizens. “We were able to show that the risk of smokers for cardiovascular diseases is more than twice that of non-smokers. However, former smokers are affected at almost the same low rate as people of the same age who never smoked,” says Brenner. “Moreover, smokers are affected at a significantly younger age than individuals who have never smoked or have stopped smoking.” For example, a 60-year-old smoker has the same risk of myocardial infarction as a 79-year-old non-smoker and the same risk of stroke as a 69-year-old non-smoker. Dose and duration of tobacco consumption also have an impact on disease risk. The more cigarettes a smoker consumes per day over a prolonged period of time, the higher his or her risk raises.
The study shows that the positive effect of smoking cessation becomes noticeable within a short period of time. “Compared to individuals who continue smoking, the risk of myocardial infarction and stroke is reduced by more than 40 percent already within the first five years after the last cigarette,” says Carolin Gellert, first author of the study. The results suggest that smoking cessation programs, which have concentrated on younger participants up to now, should be expanded to reach out to older people as well.
Last year, Hermann Brenner and his colleagues had already studied the impact of smoking on the overall mortality of people beyond the age of 60. They had used data from international studies without German participation. In their latest study, they have evaluated data from the so-called ESTHER Study whose participants are from Saarland, a state of Germany. They included those individuals who had not suffered a heart attack or stroke prior to study start and whose health status had been surveyed for up to ten years afterwards. In their evaluation, the scientists also took account of the effects of other factors such as age, gender, alcohol consumption, education and physical exercise as well as blood pressure, diabetes, cholesterol levels, body height and weight.
Carolin Gellert, Ben Schöttker, Heiko Müller, Bernd Holleczek, Hermann Brenner: Impact of smoking and quitting on cardiovascular outcomes and risk advancement periods among older adults. Eur J Epidemiol. 2013. doi: 10.1007/s10654-013-9776-0.
Key Facts About Tobacco Use Among Older Adults
Today’s generation of older Americans had smoking rates among the highest of any U.S. generation. In the mid-1960s, about 54 percent of adult males were current smokers and another 21 percent were former smokers; in 2008, about 23 percent of adult males were smokers and another 24 percent were former smokers.
In 2008, over 17 million Americans over the age of 45 smoked, accounting for over 22 percent of all adult smokers. Nine percent of Americans over 65 years of age currently smoked.
The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) with its more than 2,500 employees is the largest biomedical research institute in Germany. At DKFZ, more than 1,000 scientists investigate how cancer develops, identify cancer risk factors and endeavor to find new strategies to prevent people from getting cancer. They develop novel approaches to make tumor diagnosis more precise and treatment of cancer patients more successful. The staff of the Cancer Information Service (KID) offers information about the widespread disease of cancer for patients, their families, and the general public. Jointly with Heidelberg University Hospital, DKFZ has established the National Center for Tumor Diseases (NCT) Heidelberg, where promising approaches from cancer research are translated into the clinic. In the German Consortium for Translational Cancer Research (DKTK), one of six German Centers for Health Research, DKFZ maintains translational centers at seven university partnering sites. Combining excellent university hospitals with high-profile research at a Helmholtz Center is an important contribution to improving the chances of cancer patients. DKFZ is a member of the Helmholtz Association of National Research Centers, with ninety percent of its funding coming from the German Federal Ministry of Education and Research and the remaining ten percent from the State of Baden-Württemberg.
Benefits of Quitting Smoking for Older Adults
- Quitting smoking has proven health benefits, even at a late age. When an older person quits smoking, circulation improves immediately, and the lungs begin to repair damage. In one year, the added risk of heart disease is cut almost in half, and risk of stroke, lung disease, and cancer diminish. Among smokers who quit at age 65, men gained 1.4 to 2.0 years of life and women gained 2.7 to 3.4 years.
- Just cutting down on cigarettes, but not quitting entirely, does not reduce mortality risks from tobacco-related diseases.
- A study found that middle-aged smokers and former smokers with mild or moderate chronic obstructive pulmonary disease breathed easier after quitting. After one year the women who quit smoking had 2 times more improvement in lung function compared with the men who quit.
- Many older adults say they do not quit smoking because doing so offers no benefit at an advanced age. However, there is strong evidence that smoking cessation even late in life not only adds years to life, but also improves quality of life. Similar to this belief, most obstacles brought up by older adults for not quitting are based on incorrect information, such as the potential health risks from cessation aids like nicotine replacement therapy.
- Although most former smokers preferred quitting cold turkey, less than 5 percent will have long term success. Using a tobacco treatment plan doubles the quitting success rate. Treatments for quitting smoking have been found to be effective and could decrease health care costs. Effective treatments combine counseling and medications.
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The study, which was published in the Archives of Internal Medicine on June 11, looked at results from17 studies conducted in seven countries. Even seniors lived longer if they were willing to part with their cigarettes.
According to the researchers, smoking is one of the 10 leading risk factors for death, and takes the lives of 12 percent of males and six percent of females of the world. If current rates continue, one billion deaths due to smoking are expected in the 21st century.
Researchers reviewed studies that ranged in duration from three to 50 years and looked at anywhere from 863 participants to more than 877,000 people. One study showed that 59 percent of non-smokers were alive at age 80, compared to 26 percent of smokers. Another study showed that those who had quit before the age of 40 had the same death rates as those who had never smoked.
The researchers also found that smokers who were 60 years and older were 83 percent more likely to die at any given age than those in the same age group who had never smoked. Some causes of death - such as cancers of the mouth, pharynx, and larynx - increased up to 10 times for current smokers in that age group. Those who quit smoking still had a higher risk of dying at any given age compared to those who never picked up the habit - 34 percent - but it was much lower than those who never quit.
However, for those willing to quit, mortality was comparable with never-smokers the longer they had stopped using cigarettes.
Sibylle Kohlstädt
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Helmholtz Association of German Research Centres