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Updated: Jan 14, 2026

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More lessons from the Lung Health Study.

Janet T Holbrook1

  • 1Department of Epidemiology, Center for Clinical Trials and Evidence Synthesis, Johns Hopkins Bloomberg School of Public Health, 415 North Washington Street, Baltimore, MD 21231, United States.

American Journal of Epidemiology
|January 13, 2026
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Summary

Long-term follow-up of the Lung Health Study (LHS) confirms reduced respiratory mortality from smoking cessation interventions. While all-cause mortality benefits waned, respiratory health improvements persisted over 32.5 years.

Keywords:
COPDclinical trialssmoking cessation

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Area of Science:

  • Pulmonary Medicine
  • Clinical Trials
  • Epidemiology

Background:

  • The Lung Health Study (LHS) is a landmark randomized clinical trial investigating smoking cessation interventions.
  • Previous analyses showed benefits in all-cause and respiratory mortality.

Purpose of the Study:

  • To report the 32.5-year follow-up results of the LHS.
  • To assess the long-term impact of smoking cessation interventions on mortality.

Main Methods:

  • Enrolled 5,887 smokers aged 35-59 with mild-to-moderate airway obstruction.
  • Randomized participants to smoking cessation intervention (with or without ipratropium bromide) or usual care.
  • Utilized the National Death Index for long-term mortality tracking.

Main Results:

  • Confirmed a significant reduction in respiratory-related mortality over 32.5 years for the smoking cessation group.
  • The previously observed all-cause mortality benefit at 14.5 years was not sustained.
  • Exclusion of Canadian participants in the updated analysis did not alter qualitative findings.

Conclusions:

  • Smoking cessation interventions demonstrate a lasting benefit in reducing respiratory mortality.
  • Extended follow-up in clinical trials is crucial for understanding long-term health outcomes.
  • Trial conduct, data preservation, and long-term follow-up are vital for robust scientific evidence.