A healthy lifestyle may help ex-smokers reduce the risk of death from all causes

A healthy lifestyle may help ex-smokers reduce the risk of death from all causes

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Thursday, September 22, 2022

Ex-smokers who adhere to a healthy lifestyle are less likely to die from all causes than those who do not practice healthy habits, According to a new study by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health. A lower risk of death from specific causes, including cancer and heart and lung disease, was noted. Lifestyle interventions have not been robustly studied in former smokers, and these new findings could have important implications for 52 million former smokers in the United States.

Maintaining a healthy lifestyle – defined as doing things such as physical activity and eating a healthy diet – was associated with a 27% lower risk of death during the 19-year follow-up period, compared to not maintaining a healthy lifestyle.

The results, which appeared on September 22, 2022, in JAMA Network is opencomes from an analysis of a large group of ex-smokers who participated in The NIH-AARP Diet and Health Study.

“I was surprised to see the strong connections [with lifestyle]Maki Inoue-choi, PhD, of the Department of Cancer Epidemiology and Genetics at the National Cancer Institute, lead author of the paper. “Ex-smokers who adhered to evidence-based recommendations for body weight, diet, physical activity, and alcohol intake were less likely to die than ex-smokers who did not adhere to these recommendations.”

It is well known that quitting smoking has many health benefits, but former smokers are still more likely to develop disease and premature death than people who have never smoked.

Previous studies have indicated that people who follow healthy lifestyle recommendations, such as maintaining a healthy body weight, being physically active, eating a healthy diet, and limiting alcohol consumption, may be less likely to develop disease and die. However, few studies have investigated the benefit of such adherence among former smokers.

The current analysis included 159,937 former smokers who completed questionnaires asking about lifestyle, demographics and other health-related information between 1995 and 1996 when they joined the NIH-AARP Diet and Health Study. The participants, whose average age at study entry was 62.6 years, were followed for approximately 19 years. During the follow-up period to 2019, 86,127 participants died. Death information, including the cause of death, came from the National Mortality Index.

For each participant, the researchers calculated a total commitment score ranging from non-adherence to full adherence. The overall adherence score included individual BMI scores, based on guidelines from the World Health Organization; for diet quality, based on the Dietary Guidelines for Americans, 2010-2015; for physical activity, based on the second edition of the Physical Activity Guidelines for Americans; And for alcohol use, based on the Dietary Guidelines for Americans, 2020-2025.

Ex-smokers with the highest overall score for adherence had a 27% lower risk of death from any cause than those with the lowest score. In addition, the participants with the highest score had a 24% reduced risk of dying from cancer, a 28% lower risk of dying from cardiovascular disease, and a 30% lower risk of dying from respiratory disease. The reduced risk of death was observed regardless of health status, other health conditions, the number of cigarettes participants smoked per day, years since they quit, and the age at which they started smoking.

The researchers also evaluated the benefit of sticking to individual lifestyle recommendations. In each case, people with the highest score were less likely to die than those with the lowest score: 17% less for physical activity, 14% less for body weight, 9% less for diet quality, and 4% less for alcohol intake.

“To get the most benefit, it is best to stick to several lifestyle recommendations,” Dr. Inoue Choi noted. “But even those who adopted only one lifestyle recommendation experienced the benefits.”

The researchers caution that studies based on self-reported data can only show associations, not establish cause and effect. Although the researchers controlled for many factors that could confound the links, they said they could not rule out the possibility that other factors influenced the associations they observed.

The researchers also noted that more studies are needed to explore the association between adherence to lifestyle recommendations and risk of death among former smokers in more diverse populations.

“The NIH-AARP study is a majority white population with a relatively high socioeconomic status,” said Dr. Inoue Choi. “These research questions should be expanded to include other population groups.”

about National Cancer Institute (NCI): The NCI leads the National Cancer Program and the National Institutes of Health’s efforts to significantly reduce the spread of cancer and improve the lives of people with cancer. NCI supports a wide range of cancer research and training outside of its walls through grants and contracts. The NCI In Vitro Research Program conducts innovative, interdisciplinary, basic, multi-clinical, and epidemiological research on cancer causes, prevention, risk prediction, early detection and treatment, including research at the National Institutes of Health Medical Center – the world’s largest research hospital. Learn more about NCI’s internal research from Cancer Research Center and the Department of Cancer Epidemiology and Genetics. For more information about cancer, please visit the NCI website at cancer.gov Or call the NCI Call Center at 1-800-4-CANCER (1-800-422-6237).

About the National Institutes of Health (NIH):
NIH, the country’s medical research agency, includes 27 institutes and centers and is part of the US Department of Health and Human Services. The National Institutes of Health is the primary federal agency that conducts and supports basic, clinical, and polymedical research, investigating causes, treatments, and treatments for both common and rare diseases. For more information about the National Institutes of Health and its programs, visit www.nih.gov.

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