A healthy lifestyle may help former smokers lower their risk of death from all causes

A healthy lifestyle may help former smokers lower their risk of death from all causes
A study by researchers at the National Cancer Institute (NCI), part of the National Institutes of Health in the US, finds that former smokers who adhere to a healthy lifestyle have a lower risk of dying from all causes than those who don’t engage in healthy habits. The reduced risk of dying was observed for specific causes, including cancer and heart and lung diseases. Lifestyle interventions have not been robustly studied in former smokers, and these new findings could have important implications for the 52 million former smokers in the United States, the researchers say.
The analysis included 159,937 former smokers (with an average age of 62.6 years at study entry) who had completed questionnaires on lifestyle, demographics, and other health-related information between 1995 and 1996 when they joined the NIH-AARP Diet and Health Study. The participants, were followed for approximately 19 years and during this period 86,127 participants died. Death information, including cause of death, came from the National Death Index.
For each participant, the researchers calculated a total adherence score ranging from no adherence to full adherence. The total adherence score incorporated individual scores for body mass index, based on guidelines from the World Health Organization; for dietary 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 (i.e. 1 drink or less in a day for women and 2 drinks or less in a day for men).
Former smokers who had the highest total adherence scores had a 27% lower risk of death from any cause than those with the lowest scores. In addition, participants with the highest scores had a 24% reduction in risk of death from cancer, 28% reduction in risk of death from cardiovascular disease, and 30% reduction in risk of death from respiratory disease. The reductions in risk of death were observed regardless of health status, other health conditions, how many cigarettes participants used to smoke per day, years since they quit, and age they began smoking.
The researchers also evaluated the benefit from adherence for individual lifestyle recommendations. In each case, people with the highest score had a lower risk of death than those with the lowest score: 17% lower for physical activity, 14% lower for body weight, 9% lower for diet quality, and 4% lower for alcohol intake.
The researchers cautioned that studies based on self-reported data can only show associations, not establish cause and effect and note that more studies are needed to explore the associations between adhering to lifestyle recommendations and risk of death among former smokers in more diverse populations.
Source: Inoue-Choi M, Ramirez Y, Fukunaga A, Matthews CE, Freedman ND. Association of Adherence to Healthy Lifestyle Recommendations With All-Cause and Cause-Specific Mortality Among Former Smokers. JAMA Netw Open. 2022;5(9):e2232778. doi.org/10.1001/jamanetworkopen.2022.32778