Smoking after age 65 years and mortality in Barcelona, Spain

The objective of this study was to assess the risk of dying associated with smoking after the age of 65 years and the benefits of quitting smoking, taking into account baseline health status. The study was carried out in Barcelona, Spain, a southern European city with an increase in smoking prevalence and lifestyle different from those of other areas where hazards of smoking have been studied. A follow-up study begun in 1986 was carried out in 477 males (94.3% of the original cohort) who were randomly selected by census from members of the Barcelona general population aged > or =65 years. Vital status as of October 1994 and, where applicable, cause of death (cardiovascular disease, cancer, or respiratory disease) were assessed. The relative risk of dying was 2.11 (95% confidence interval (CI) 1.37-3.26) times higher in current smokers and 1.53 (95% CI 1.03-2.27) times higher in former smokers than in never smokers. Quitting smoking after the age of 65 years reduced the relative risk of dying to 0.77 (95% CI 0.51-1.16) in comparison with continuing to smoke, although persons who stopped smoking had poorer self-perceived health and were more frequently reported to suffer from cardiovascular disease (p < 0.05). This study confirms that the effects of smoking extend to later life in this elderly general population, with a magnitude as great as that seen in previous studies with different populations. In addition, it indicates that stopping smoking after age 65 reduces the risk of dying.