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- Title
The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial.
- Authors
Anthonisen NR; Skeans MA; Wise RA; Manfreda J; Kanner RE; Connett JE; Lung Health Study Research Group; Anthonisen, Nicholas R; Skeans, Melissa A; Wise, Robert A; Manfreda, Jure; Kanner, Richard E; Connett, John E
- Abstract
<bold>Background: </bold>Randomized clinical trials have not yet demonstrated the mortality benefit of smoking cessation.<bold>Objective: </bold>To assess the long-term effect on mortality of a randomly applied smoking cessation program.<bold>Design: </bold>The Lung Health Study was a randomized clinical trial of smoking cessation. Special intervention participants received the smoking intervention program and were compared with usual care participants. Vital status was followed up to 14.5 years.<bold>Setting: </bold>10 clinical centers in the United States and Canada.<bold>Patients: </bold>5887 middle-aged volunteers with asymptomatic airway obstruction.<bold>Measurements: </bold>All-cause mortality and mortality due to cardiovascular disease, lung cancer, and other respiratory disease.<bold>Intervention: </bold>The intervention was a 10-week smoking cessation program that included a strong physician message and 12 group sessions using behavior modification and nicotine gum, plus either ipratropium or a placebo inhaler.<bold>Results: </bold>At 5 years, 21.7% of special intervention participants had stopped smoking since study entry compared with 5.4% of usual care participants. After up to 14.5 years of follow-up, 731 patients died: 33% of lung cancer, 22% of cardiovascular disease, 7.8% of respiratory disease other than cancer, and 2.3% of unknown causes. All-cause mortality was significantly lower in the special intervention group than in the usual care group (8.83 per 1000 person-years vs. 10.38 per 1000 person-years; P = 0.03). The hazard ratio for mortality in the usual care group compared with the special intervention group was 1.18 (95% CI, 1.02 to 1.37). Differences in death rates for both lung cancer and cardiovascular disease were greater when death rates were analyzed by smoking habit.<bold>Limitations: </bold>Results apply only to individuals with airway obstruction.<bold>Conclusion: </bold>Smoking cessation intervention programs can have a substantial effect on subsequent mortality, even when successful in a minority of participants.
- Publication
Annals of Internal Medicine, 2005, Vol 142, Issue 4, p233
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-142-4-200502150-00005