Cigarette Smoking

New Evidence That Cigarette Smoking Remains the Most Important Health Hazard

Steven A. Schroeder, M.D.

N Engl J Med 2013; 368:389-390January 24, 2013DOI: 10.1056/NEJMe1213751

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Everyone knows cigarette smoking is bad for you. Most people in the United States assume that smoking is on its way out. But the grim reality is that smoking still exerts an enormous toll on the health of Americans, as documented in two articles in this issue of the Journal.1,2 Both articles review mortality trends over time for men and women according to smoking status, and both confirm that smoking remains a huge threat to the public's health.

Jha et al. review data from the U.S. National Health Interview Survey, which involved 113,752 women and 88,496 men 25 years of age or older who were interviewed between 1997 and 2004. The investigators examined the rates and causes of death by the end of 2006.1 Within the age group 25 to 79 years, the mortality of current smokers of both sexes was three times that of participants who had never smoked. Diseases attributable to smoking accounted for about 60% of smokers' deaths. The benefits of quitting smoking were dramatic for all age groups, with substantial gains in life expectancy, as compared with participants who had continued to smoke. Those who quit between the ages of 25 and 34 years lived 10 years longer; those who quit between ages 35 and 44 gained 9 years, those who quit between ages 45 and 54 gained 6 years, and those who quit between ages 55 and 64 gained 4 years. These differences persisted after adjustment for such potentially confounding variables as educational level, alcohol use, and adiposity./.../