Smoking Cessation Resource Center: Clinical Studies

The Effects of a Smoking Cessation Intervention on 14.5-Year Mortality

Nicholas R. Anthonisen, MD; Melissa A. Skeans, MS; Robert A. Wise, MD; Jure Manfreda, MD; Richard E. Kanner, MD; and John E. Connett, PhD, for the Lung Health Study Research Group
February 15, 2005

Background:
Randomized clinical trials have not yet demonstrated the mortality benefit of smoking cessation.

Objective:
To assess the long-term effect on mortality of a randomly applied smoking cessation program.

Design:
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.

Setting:
10 clinical centers in the United States and Canada.

Patients:
5887 middle-aged volunteers with asymptomatic airway obstruction.

Measurements:
All-cause mortality and mortality due to cardiovascular disease, lung cancer, and other respiratory disease.

Intervention:
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.

Results:
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.

Limitations:
Results apply only to individuals with airway obstruction.

Conclusion:
Smoking cessation intervention programs can have a substantial effect on subsequent mortality, even when successful in a minority of participants.

Contact us for more information on this study.

<< Back