Smokers who engage in a smoking cessation program increase their survival, shows a large trial

Smokers who engage in a smoking cessation program see on survival increase almost 15 years later, shows an analysis of a large randomized trial published in the "Annals of Internal Medicine
The Lung Health Study is unique in assessing the value of smoking cessation in a randomized controlled trial. In addition, its size and duration are used to accurately measure the risks associated with smoking, said in a statement the National Heart, Lung and Blood Institute (NHLBI, depending on IHN), which funded the study.

According to the researchers, this is the first randomized study to evaluate the long-term interest of a smoking cessation program and demonstrate that this intervention will increase survival.

This study, initiated in 1986, covers 5,887 smokers aged 35 to 60 who do not consider themselves ill, but show signs of airway obstruction.

Participants were divided into a smoking cessation ten-week program, including sessions with a tobacco specialist for behavior change and the use of nicotine gum, and no program.

At 5 years, 21.7% of participants in the intensive smoking cessation program had quit against 5.4% in the control group.

After a follow-up of 14.5 years, 731 people died: 33% of lung cancer, 22% of cardiovascular disease, 7.8% of respiratory disease other than cancer and 2.3% of unknown cause.

Data analysis by intention to treat shows that the death rate from all causes was significantly lower in patients who completed the program compared to the control group, with 8.83 deaths per 1000 person-years against 10.38.

For participants who were still abstinent at the end of follow-up, the benefit was even more apparent with a rate of 6.0 per 1000 person-years against 11.0.

With the smoking cessation program, the overall risk of death is 14.5 years almost halved among abstainers compared to those who continued to smoke. The risk of cardiovascular death was reduced it by about a third and one from lung cancer by nearly half.

The authors note that the program is more effective in 35-45 years than in older people. A simple test, the measurement of breath by spirometry, would thus be detected in young smokers who might derive the greatest benefit of an intensive smoking cessation program, says one of the authors in a statement of the American College of Physicians.

These results show that intensive smoking cessation followed over five years can lead to a substantial and significant reduction in all-cause mortality in people with mild to moderate obstruction of the airways, they conclude.

In an editorial accompanying the study, Dr. Jonathan Samet of Johns Hopkins University in Baltimore believes that the LHS test shows that smoking is responsible for an increased risk of death and that "no one can seriously argue otherwise in the light of evidence from this randomized trial. "