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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