Smoking and Death in Women

Unless you've been living under some slimy rock, you're well aware that there is nothing even remotely beneficial about smoking, and anyone who's listened to PodMed has heard Rick and me pontificate about what an eloquent indictment of our society it is that such a product is actually allowed to be sold anywhere in the world.  After all, people die of smoke inhalation.  And in this week's Lancet, an elegant study shows just how many women have died as a result of this repulsive habit.

The first thing that must be noted about this study is its incredible size.  Over 1.3 million women in the UK were recruited to participate.  Wow.  Such a number could only have been possible in a European country, where centralization of healthcare is much more common, as is record keeping.  Recruitment took place from 1996 to 2001, with these women having been born between 1938 and 1946. They were followed to January 1, 2011. All women with pre-existing disease were excluded from the study.

Twenty percent of the women were smokers at the time of recruitment, 28% were former smokers, and 52% had never smoked. During the follow up 6% of the participants died at a mean age of 65 years. Here's the finding that should be trumpeted from the rooftops: women who smoked died about 11 years earlier than nonsmokers.  That's 11 years, folks, as our colleague at Johns Hopkins, Enid Neptune, a pulmonologist frames it, that's the difference between watching your grandchild reach his third birthday and his fourteenth birthday: quite a lot of life lost.  It's also important to emphasize that at the time of recruitment, none of these women felt ill or had symptoms of disease, so things went fast. The excess mortality among women smokers was largely accounted for by diseases like lung cancer that are clearly caused by smoking.

There is some good news from this study: women who stopped smoking reduced their risk of mortality substantially.  Those who stopped by age forty had only a 20% increased risk compared to never smokers, while those who stopped by age 30 retained only a 5% risk.  A very persuasive reason to stop, especially juxtaposed against the fact that mortality risk remained among smokers even when they reported smoking 10 or fewer cigarettes per day.

Rick points out that this is the first study to gather substantial long term data on women smokers, who didn't begin smoking in large numbers until the 1960s.  I recall an advertising campaign for the Virginia Slims brand of cigarettes using the slogan 'you've come a long way, baby.' How unfortunate that independence  also sorted with adoption of the male-associated  habit of smoking! And indeed, that's the concern now.  In developing countries, as women gain more status they are also smoking more, and when that habit is added to environments where the air quality is often poor, an epidemic of early death looms.

Other topics this week on PodMed include an outbreak of mumps in a select group of people in NEJM, use of topical ivermectin to treat head lice in the same issue, and consumption of omega-3 fatty acids and stroke prevention in BMJ.  Until next week, y'all live well.

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Pratik December 14, 2012 at 9:23 am

Smoking is an adidction only he can beat and only if he wants to. You can not fix an adidct or any other personality disorder only the adidct can. Giving him nicotine gum without his knowledge is a very bad idea, there are extreme health risks there. An unknown heart disease that can even be prevalent in young people. Nicotine poisoning (over dose of nicotine can kill.) Nagging, threatening or money doesn't change the habit either. I don't like the word habit though a habit is involved as well as the adidction. This tends to soften the reality that it is an adidction. One of the hardest to kick by the way. And you are not going to kick it unless you really want to. Like any other habit it might take several attempts to quit.If you want to help prayer is a power full tool, even scientist recognize this, but don't pray that he gets sick when he smokes that is not a prayer but a curse. How would you like to get sick every time you did something you couldn't help. Besides it might make him miss school or work. Better to pray that he looses the desire and takes an interest in what it is doing to his health. Add that the cravings, habits involved will go away and it will look unattractive to him. A couple of times when I tried to quit I found my self reaching for my top pocket or bringing my hands to my mouth. Some people start chewing or sucking on pens and pencil. I finally quit with prayer and have no cravings or after habits. Unfortunately I waited to long and there is some breathing problems. Shortness of breath. You see I started at 13 and didn't quit till I was 50 something. When he is ready there are on line help tips. If you poo poo prayer keep in mind that a lot of adidction programs, such as Alcoholics Anonymous and Narcotics Anonymous recognize a higher power and spirituality is one of the cycles involved in the cure. Go to a church and get some people to pray with you. the bible refers to one or more gathered in His name. I like Pentecostal or spirit filled churches because there faith in healing by prayer is strong. You perhaps noticed in the news that faith healing that were going on in Lakewood.Hope this helps.

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