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Healthy Lifestyle in Former Smokers Associated With Lower Mortality Risk
Former smokers who adopted a healthy lifestyle had a 27% lower risk of death over 19 years compared with former smokers who did not follow healthy lifestyle recommendations, according to a study published online in JAMA Network Open.
“The benefits of smoking cessation are strong and clear,” wrote study lead author Maki Inoue-Choi, PhD, and coauthors from the the National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland.
Although former smokers still have an increased risk of disease and premature death compared with people who have never smoked, few studies have investigated the benefit of a healthy lifestyle in former smokers.
“I was surprised to see the robust associations [with lifestyle],” said Dr Inoue-Choi. “Former smokers who adhered to evidence-based recommendations for body weight, diet, physical activity, and alcohol intake had a lower risk of mortality than former smokers who didn’t adhere to these recommendations.”
The study included 159,937 former smokers from the National Institutes of Health–AARP Diet and Health Study. Between 1995 and 1996, when they were an average age of 62.6 years, participants completed questionnaires on their lifestyle, demographics, and other health-related information. Some 86,127 participants died over a mean follow-up of 18.9 years.
For each participant, adherence to evidence-based healthy lifestyle recommendations were scored for body weight, diet quality, physical activity, and alcohol intake. Scores for each domain were added to create a total adherence score.
The highest total adherence scores were linked with a 27% lower risk of death from any cause compared with the lowest scores, according to the study. Specifically, participants with the highest scores had a 30% reduction in risk of death from respiratory disease, a 28% reduction in risk of death from cardiovascular disease, and 24% reduction in risk of death from cancer. Mortality risk was reduced regardless of health status, comorbid conditions, how many cigarettes participants used to smoke per day, years since quitting, and age when smoking began.
As for individual healthy lifestyle recommendations, the study found that, compared with the lowest adherence scores, those with the highest scores for physical activity had a 17% lower risk of death; for body weight, 14% lower risk of death; for diet quality, 9% lower risk of death; and for alcohol intake, 4% lower risk of death.
“To have the greatest benefit, it is better to adhere to many lifestyle recommendations,” said Dr Inoue-Choi. “But even those who adopted just a single lifestyle recommendation experienced benefits.”
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