Jan. 23 2013
WASHINGTON, DC — Two new studies published today in the New England Journal of Medicine show that smoking remains a huge public health problem in the United States, but smokers who quit between the ages of 25 and 34 regained nearly the same life expectancy as people who had never smoked. The message to smokers is clear: The sooner you quit, the greater the health benefits.
These studies are a timely reminder to the nation's elected officials that the battle against tobacco is far from over, but they can accelerate progress by implementing proven strategies to help smokers quit and prevent kids from starting to smoke in the first place. These measures include expanded health insurance coverage for tobacco cessation treatments, media campaigns that encourage smokers to quit and discourage kids from smoking, tobacco tax increases and strong smoke-free air laws.
Despite the enormous health benefits of quitting and surveys finding that most smokers (about 70 percent) want to quit, only a small percentage succeed in doing so each year. To help more smokers quit, the Obama Administration must effectively enforce the requirement in the health care reform law that all new private health insurance plans cover smoking cessation therapies, without cost-sharing. A recent study by the Georgetown University Health Policy Institute found that many health plans are falling short, with confusing language, gaps in coverage and cost-sharing requirements that appear to conflict with the law.
The Centers for Disease Control and Prevention must continue the highly successful media campaign it launched in March 2012. The CDC campaign, called Tips from Former Smokers, more than doubled the number of smokers seeking assistance from smoking cessation quitlines (1-800-QUIT-NOW) and led to a 428 percent increase in visitors to the www.smokefree.gov website. It is encouraging that the CDC is planning a similar campaign this year. Congress should support the Prevention and Public Health Fund that was created by the health reform law and is providing funding for the CDC campaign and other tobacco prevention and cessation initiatives.
The two new studies demonstrate both the huge scope of the tobacco epidemic and the tremendous health benefits from reducing tobacco use:
The first study (21st-Century Hazards of Smoking and Benefits of Cessation in the United States) finds that smoking on average reduces a person's life expectancy by at least 10 years. But smokers can significantly extend their life expectancy by quitting. Those who quit between the ages of 25 and 34 lived about 10 years longer on average. Those who quit between 35 to 44, 45 to 54, and 55 to 64 gained 9, 6 and 4 years of life, respectively.
The second study (50-Year Trends in Smoking-Related Mortality in the United States) found that death rates among female smokers — previously documented to be lower than those among male smokers — have increased and converged with those of men for lung cancer, chronic obstructive pulmonary disease (COPD) and other tobacco-related diseases. The researchers attributed this increase in large part to a convergence in smoking patterns among men and women since the 1960s, with women starting to smoke earlier in adolescence and until recently smoking more cigarettes per day. The researchers write that this finding confirms a prediction that "women who smoke like men die like men."
In another key conclusion, the second study finds that the death rate from COPD continues to increase among both male and female smokers in contrast to a significant decrease in risk among men who never smoked. The authors write, "A plausible explanation for the continuing increase in deaths from COPD among male smokers is that cigarettes marketed since the late 1950s have undergone design changes that promote deeper inhalation of smoke." Similarly, the study notes that cigarette design changes may also have contributed to an increase in one form of lung cancer (called peripheral adenocarcinomas) that has offset declines in other forms of lung cancer. These changes occurred as tobacco companies marketed so-called "light" and "low-tar" cigarettes as a less harmful alternative despite knowing this was not the case.
These findings are an important reminder that tobacco companies have a long history of manipulating their products in ways that make them more appealing, more addictive or more harmful. They also underscore why the Food and Drug Administration must aggressively exercise its new authority over tobacco products, including the authority to stop such tobacco industry manipulation that harms public health.
Tobacco use kills more than 400,000 Americans and costs the nation $96 billion in health care bills each year. While the U.S. has made significant progress in reducing smoking, these studies remind us that there is still much work to do to win the fight against the nation's number one cause of preventable death.