Smoking is critical to our health and has been reported to kill approximately 6 million people per year worldwide. Researchers have proven that the younger we begin to smoke, and the longer we take to stop, increases our overall risk of premature death. Therefore, it is in our best interest to discourage the practice among youths and encourage adults to stop smoking regardless of age.
The World Health Organization (WHO) describes Tobacco products as one of the world’s biggest public health threats. Tobacco products are those made or derived from the tobacco plant, and are intended for human consumption. The most popular example of a tobacco product is the cigarette.
The American Lung Association (ALA) describes cigarettes as products containing approximately 600 ingredients which, when burned, produce over 7,000 dangerous chemicals, some of which are poisonous and known to cause diseases such as cancer. One such ingredient is nicotine, a highly addictive and harmful substance found in almost all tobacco products.
With that being said, it is no wonder that statistics have shown that smoking results in the death of roughly 6 million people per year around the world; with over 5 million of those deaths belonging to current smokers and more than 600,000 belonging to non-smokers who inhale second-hand smoke. However, despite global successes for tobacco control, tobacco remains a leading cause of cancer and premature death worldwide. As such, many organizations have implemented hard-hitting anti-tobacco and anti-smoking campaigns, that include graphic images on products such as cigarette packages, as a warning against the associated risks of smoking, in an effort to discourage the practice; while many researchers have dedicated their time to investigating how the practice affects the ever-aging population.
In a study published in the American Journal of Preventive Medicine, researchers sought to determine the long-term effects of cigarette smoking on the number of occurring deaths (mortality) from the age of initiation to cessation in older populations. The researchers conducted an NIH-AARP Diet and Health Study using two lifestyle questionnaires; one broad-range lifestyle questionnaire which they mailed to 160,113 participants in 1995, and one detailed lifestyle follow-up questionnaire in 2004 -2005.
Those that completed the follow-up questionnaire were monitored for mortality until December 31st, 2011, through the National Death Index and the National Center for Health Statistics. The questionnaire was standardized for height, sex, race, education and select medical conditions; hypertension, chronic obstructive pulmonary diseases (COPD), cancer, stroke, and heart attack. All participants were at least 70 years of age at the time of the follow-up survey. The elderly proved to be ideal subjects as they have a very long lifetime prevalence of cigarette smoking; thus, providing the best opportunity to examine the associated risks of smoking and the benefits of quitting, even in old age.
To analyze the effects of cigarette smoking, the population was divided into 2 groups; those with select medical conditions and those without. Both groups were then asked to report if they ever smoked 100 cigarettes to date, as well as how many cigarettes they smoked each day (smoking intensity). The participants were then further classified into 3 subgroups:
- Current Smokers (6% of the population) – those who reported smoking in at least their 70s or who had quit smoking within the last year
- Former Smokers (~56% of the population) – those who quit smoking more than a year ago
- Never Smokers (38% of the population) – those who had never smoked in their lives
From the results, it was determined that males not only smoked more than females, but started at a much younger age (before 15 years). It also showed that females were more likely to be Never Smokers than males. Hence, mortality rates were lower among women than men. However, all other risk factors (all-cause mortality, lung cancer, other smoking cancer, respiratory infection, heart disease and stroke) were relatively the same for both sexes.
Current Smokers had the greatest number of deaths and were more than 3x as likely to die than Never Smokers, who had the least number of deaths. Former smokers who quit smoking earlier in life received the largest benefit from stopping, especially those who quit before their 60s. Those who quit after their 60s were found to be in fair/poor health and reported greater numbers of COPD than Never Smokers and those who quit before age 60. It was also observed that both Current Smokers and Former Smokers who began smoking at earlier ages had a progressively higher risk of mortality as opposed to those who started later in life or never started at all.
While this study had a few limitations, it also had many strengths. In addition to lacking diversity – as most of the participants were Caucasian – the results did not take into consideration any possible lifestyle changes in the participants’ cigarette use over the years, which resulted in inaccurate results. However, due to the large number of participants in the NIH-AARP Study, the detailed examination of several smoking-related predictors of mortality and the use of a population with a long lifetime prevalence, the results obtained proved consistent across different populations and as such, are valid. Future studies should focus on more diverse and even older populations.
To summarize, smoking is critical to our health. The younger we begin to smoke, and the longer we take to stop, both increase our overall risk of getting a variety of illnesses and diseases that could lead to our premature death. Therefore, it is in our best interest to discourage the practice among youths and encourage adults to stop smoking regardless of age.