NHLBI Study Shows Smoking Cessation Programs Improve
Survival
New findings from the Lung Health Study (LHS) show
that intensive smoking cessation programs can significantly
improve long-term survival among smokers. Supported
by the National Heart, Lung, and Blood Institute (NHLBI),
LHS is a landmark study that differs from many other
studies of cigarette smoking in that it was a randomized,
controlled clinical trial -- considered the gold standard
in determining cause and effect; furthermore, the
size and duration of LHS enabled it to more accurately
measure the risks associated with smoking than other
clinical trials. NHLBI is part of the National Institutes
of Health.
LHS followed nearly 5,900 middle-aged smokers who had
mild to moderately abnormal lung function but were
otherwise healthy when they enrolled in the study.
Participants were assigned to either a 10-week intensive
smoking cessation program or to usual care (no intervention).
The intervention program included behavior modification
and use of nicotine gum, with a continuing five-year
maintenance program to minimize relapse. After five
years, approximately 22 percent of the participants
in the smoking cessation program were sustained quitters,
with nearly 90 percent of them continuing their success
after 11 years. About 5 percent of those who did not
receive the intervention were sustained quitters after
five years. After an average of 14.5 years, the death
rate among those in the smoking cessation program
was about 15 percent lower compared to those who received
usual care. The results are published in the February
15, 2005, issue of the Annals of Internal Medicine.
“This study shows the substantial impact smoking
cessation programs can have on public health, even
if small numbers of participants successfully quit,”
said Gail Weinmann, MD, director of the NHLBI Airway
Biology and Disease Program.
Researchers also analyzed mortality data according
to smoking habit regardless of whether participants
were in the intervention or usual care groups. At
the end of the study they found that sustained quitters
had nearly half the overall death rate of those who
continued to smoke. In particular, death rates of
sustained quitters compared to smokers were nearly
one-third lower for coronary heart disease and for
cardiovascular disease, and less than half for lung
cancer.
In an accompanying editorial, Jonathan Samet, MD, MS,
of the Johns Hopkins Bloomberg School of Public Health,
notes that the LHS findings prove that “smoking
is causally responsible for the increased risk for
death in smokers.” He asserts, “No one
can make a serious claim to the contrary in light
of this randomized trial evidence.”
Smoking is the single most avoidable cause of disease,
disability, and death in the United States. According
to the Centers for Disease Control and Prevention,
approximately 22.5 percent of adults (46 million)
and 26 percent of high school seniors smoke. Smoking
contributes to more than 440,000 deaths per year.
Dr. Weinmann is available to comment on the study.
To interview Dr. Weinmann, please call the NHLBI Communications
Office at (301) 496-4236. To interview an expert about
smoking and cancer, please contact the National Cancer
Institute Press Office at (301) 496-6641.
Clinical centers for the Lung Health Study were:
· Baltimore, Maryland: Johns Hopkins University
School of Medicine
· Birmingham, Alabama: University of Alabama
at Birmingham
· Cleveland, Ohio: Case Western Reserve University
· Detroit, Michigan: Henry Ford Hospital
· Los Angeles, California: University of California
· Pittsburgh, Pennsylvania: University at Pittsburgh
· Portland, Oregon: Oregon Health Sciences
University
· Rochester, Minnesota: Mayo Clinic
· Salt Lake City, Utah: University of Utah
· Winnipeg, Manitoba: University of Manitoba
· Minneapolis, Minnesota: University of Minnesota
(Data Coordinating Center)
For more information about the Lung Health Study, visit
http://www.biostat.umn.edu/lhs/.
Information about chronic obstructive pulmonary disease,
a condition in which the lung is damaged – usually
due to cigarette smoking -- is available at http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html.
Resources to help smokers quit are available at www.smokefree.gov.
NHLBI is part of the National Institutes of Health
(NIH), the Federal Government's primary agency for
biomedical and behavioral research. NIH is a component
of the U.S. Department of Health and Human Services.
Additional information about NHLBI-supported research
and educational programs are available online at the
NHLBI website, www.nhlbi.nih.gov.
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