Clean living linked to lower mortality in former smokers

An important message for former smokers: you can overcome a history of vice through virtue.

Researchers have found that people with a history of smoking who exercise regularly, eat nutritious foods and maintain a healthy weight reduce their risk of premature death by nearly 30% compared to those who don’t adopt such good habits.

“Being involved in more aspects of a healthy lifestyle was associated with a lower risk of death than being involved in one aspect,” says Maki Inoue-Choi, PhD, an epidemiologist at the National Cancer Institute, Bethesda, Maryland, who led the new study. led. “Former smokers may benefit from following any of the healthy lifestyle recommendations, but gain an even greater benefit if they follow more of it.”

For the study, published in JAMA network opened, Inoue-Choi and her colleagues analyzed study data from 159,937 former smokers in the United States. The data was part of a larger look at approximately 570,000 people enrolled in the National Institutes of Health-AARP Diet and Health Study. The primary outcome of the study was death on or before December 31, 2019, and the participants had a mean follow-up period of approximately 19 years.

Former smokers who adhered to the health recommendations were as much as 27% less likely to die during the study period than those who did not follow the recommendations.

The effect turned out to be cumulative. The risk of all-cause mortality was 12% lower for those who adhered to health recommendations on average and 4% lower for those who adhered to slightly above average. People who adhered more closely to the recommendations were also less likely to die from cancer, cardiovascular disease and respiratory disease during the study period, they found.

Overall death rates were lower among those who quit smoking earlier. However, better adherence to healthy lifestyle recommendations was associated with a lower risk of death, regardless of when a person had stopped smoking.

More than 50 million Americans have quit smoking, according to Inoue-Choi. Previous studies have shown significant health benefits for a healthier lifestyle and for smoking cessation.

“Former smokers are a large group of people who may be particularly motivated by their smoking cessation to adhere to other evidence-based recommendations for a healthy lifestyle,” she said.

There is some evidence that alcohol use and smoking have increased during the pandemic, but very little research has been done on the effects of this increase on former smokers, according to Inoue-Choi.

According to Hilary Tindle MD, MPH, founder and director of the Vanderbilt Center for Tobacco Addiction and Lifestyle, Nashville, Tennessee, the new findings are important because of the message they send to patients.

“You don’t have to be the epitome of health — mid-range adherence still reduces mortality. Even following some of the recommendations will promote your overall health,” Tindle said.

JAMA Netw Open. Published online September 22, 2022. Full text

The study was funded by the National Cancer Institute’s Intramural Research Program for the Official Duties of Government Employees. Inoue-Choi does not report any relevant financial relationships. Tindle does not report any relevant financial relationships.

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