The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial
Nicholas R Anthonisen1, Melissa A Skeans, Robert A Wise
1University of Manitoba, Winnipeg, Manitoba, Canada.
Annals of Internal Medicine
|February 16, 2005
Summary
A smoking cessation program significantly lowered long-term mortality in individuals with airway obstruction. This intervention demonstrated a mortality benefit, even when only a minority of participants successfully quit smoking.
Area of Science:
- Pulmonary Medicine
- Public Health
- Clinical Trials
Background:
- Randomized clinical trials have not conclusively demonstrated a mortality benefit for smoking cessation.
- Identifying effective smoking cessation strategies is crucial for public health.
Purpose of the Study:
- To evaluate the long-term impact of a structured smoking cessation program on all-cause mortality.
- To assess mortality differences between a smoking intervention group and a usual care group.
Main Methods:
- The Lung Health Study was a randomized clinical trial involving 5887 middle-aged volunteers with asymptomatic airway obstruction.
- Participants received either a 10-week smoking cessation intervention or usual care, with vital status followed for up to 14.5 years.
- Mortality outcomes included all-cause, cardiovascular disease, lung cancer, and respiratory disease mortality.
Main Results:
- The smoking cessation intervention group showed significantly lower all-cause mortality (8.83 per 1000 person-years) compared to the usual care group (10.38 per 1000 person-years; P = 0.03).
- The hazard ratio for mortality in the usual care group was 1.18 (95% CI, 1.02 to 1.37), indicating increased risk.
- While 21.7% of intervention participants quit smoking by 5 years, mortality benefits were observed even with this success rate.
Conclusions:
- Smoking cessation intervention programs can significantly reduce subsequent mortality in individuals with airway obstruction.
- The study highlights the long-term public health benefits of targeted smoking cessation efforts.
- Findings are specific to individuals diagnosed with airway obstruction.
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