Should Our Older Smokers Quit Smoking?

Life can be compared to the arcade game, Whac-A-Mole.  It's inevitable that we're going to die from something.  Some disease is going to rear its ugly head if we beat down another one.  If it's not heart disease, it just well might be cancer that kills us; after all, these two conditions still ranked as the greatest killers in 2008 in the States as published in the National Vital Statistics Reports last week.  And if it's not cancer, then perhaps it'll be emphysema or stroke.

I mention this because as I make more & more home visits, I encounter older adults who've either not heard the message that smoking cigarettes kills you or they've chosen to ignore the message and continue to smoke since they've made it this far and/or have given up all other vices at this ripe old age.  Until yesterday, I would've agreed.  After all, it's your life to live how you want to live as long as it doesn't impact me.

But in a study published in yesterday's Archives of Internal Medicine, the authors analyzed data from 17 studies of 7 populations and came to several conclusions.  First, current smoking is associated with greater all-cause mortality (in each & every study).  Second, the more you smoke for a greater period of time, the greater your chance of premature death.  Third & finally, excess mortality decreases w/duration of cessation, even in patients 80yo & beyond.  In other words, there's no bad time to quit and there's no age at which it's too old to quit.  And by quitting, you lower your chance of dying from any and all-causes - you've just whacked all the moles all at once!

If you're curious about the statistics, the Asian & European  populations ranged from 863 to 877,243 participants, and were followed for 3 to 50 years.  Current smokers had an 83% greater risk of death while former smokers had a 34% greater risk of death, both compared to never smokers.  And as noted above, relative risk of death in former smokers decreased w/time since cessation.  To put it succinctly, the longer you stay quit, the better off you are.  In fact, the authors concluded that even those elderly who managed to smoke their whole life w/o suffering any clinically apparent negative health consequences would benefit from cessation and should be encouraged to quit smoking.  Even the editorialists, who typically take a negative point-of-view against any study, agreed that you're never too old to quit.

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