By The Washington Post

Published: Wednesday, January 23, 2013, 8:52 p.m.
Updated: Wednesday, January 23, 2013

Smokers who quit by about age 40 can stave off an early death, according to a landmark study that fills key gaps in knowledge of smoking-related health ills.

While smokers who never stop lose about a decade of life expectancy, those who quit between ages 35 and 44 gained back nine of those years, the study found.

Moreover, the benefits of dropping the habit extend deep into middle age. Smokers who quit between 45 and 54 gained back six otherwise lost years, and those who quit between 55 and 64 gained four years.

Quitting young, before age 35, erased the entire decade of lost life expectancy.

The message: It's never too late to quit, even for heavy smokers with decades of puffing behind them.

But younger smokers should not be lulled into thinking they can smoke until 40 and then stop without consequences, said Prabhat Jha, an epidemiologist at the Center for Global Health Research in Toronto. Jha led the new study, published online Wednesday in the New England Journal of Medicine.

That's because the risks of lung cancer and other respiratory diseases linger for years after stubbing the last butt.

Most of the gains in life expectancy come because the twin risks of heart disease and stroke quickly drop after smoking ends. Both diseases occur as the byproducts of tobacco smoke trigger clotting in the arteries, a process that can rapidly reverse.

Damage to the lungs, meanwhile, takes longer to heal. “The risk for lung cancer doesn't disappear and the risk of respiratory disease doesn't disappear” in former smokers, said Jha. “But the acute risk for heart attack or stroke pretty much disappears.”

While the study delivered good news for quitters, it hammered home the message that continuing to smoke carries grave risks.

Smokers in the study died early at a rate triple that of people who never smoked. And few smokers reached age 80. Just 38 percent of female smokers and 26 percent of male smokers hit that milestone, while 70 percent of women who never smoked and 61 percent of men who never smoked did.

The study linked surveys of 217,000 adults collected for the federal National Health Interview Survey between 1997 and 2004 to cause-of-death records in the National Death Index.

Previous long-term studies of smokers followed specific groups who were likely healthier than the general population, such as nurses or physicians, said Jha, marking the new study as more representative of the risks of smoking — and the benefits of dropping the habit — across the entire nation.

A second report, also published in the New England Journal of Medicine, showed that smoking-related deaths among women have soared in recent decades. For the first time since research on smoking and health began in the 1950s, the rate of smoking-related deaths is now nearly equal between male and female smokers.

Women took to cigarettes in large numbers only after World War II, lagging behind men by about 20 years. The consequences of that shift are just now reaching women in their mid-50s and older. Meanwhile, lung cancer risk in male smokers leveled off in the 1980s.

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