Smoking cessation · Does stopping smoking change mortality?
The effects of a smoking cessation intervention on 14.5-year mortality
| Design | Long-term follow-up of a randomised controlled trial |
|---|---|
| Treatment | Intensive smoking cessation intervention |
| Control | Usual care |
| Population | 5887 middle-aged smokers with mild-to-moderate airflow obstruction |
| Follow-up | Up to 14.5 years |
| Primary endpoint | All-cause mortality |
| Result | At 5 years, 21.7% of the intervention group had stopped smoking versus 5.4% of usual care. Over up to 14.5 years, 731 patients died — 33% of lung cancer, 22% of cardiovascular disease, 7.8% of non-malignant respiratory disease. All-cause mortality was significantly lower in the intervention group. |
| Secondary endpoints | Cause-specific mortality, lung function decline |
Smoking cessation intervention programs can have a substantial effect on subsequent mortality, even when successful in a minority of participants.
The trial authors, in the published abstract
The most powerful argument in respiratory medicine for persisting with an intervention that mostly fails: a 16 percentage point difference in quit rates translated into a measurable mortality difference over fourteen years. No inhaled therapy for COPD — not TORCH, not IMPACT — has produced anything comparable.
Anthonisen NR, Skeans MA, Wise RA, et al. The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial. Ann Intern Med 2005 Feb 15;142(4):233-9.