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Editor's Note
August 20, 2019

Smoking Cessation and Reduction of Cardiovascular Disease Risk

Author Affiliations
  • 1Associate Editor, JAMA
JAMA. 2019;322(7):651. doi:10.1001/jama.2019.11166

Smoking cessation improves cardiovascular health, but not right away. Studies have come to different conclusions about how long it takes for the excess risk associated with smoking to subside to the level of a never smoker, with estimates varying widely, from 2 to 20 years. The study by Duncan et al,1 which was based on repeated assessments of tobacco exposure, other risk factors, and cardiovascular disease (CVD) outcomes, provides estimates of cardiovascular risk among former smokers that are likely to be more precise and accurate than those of previous studies. This information is important for clinicians and patients. According to these new analyses, a former smoker’s risk of CVD does not approximate the risk of a never smoker until 10 to 15 years have elapsed since cessation. The risk of CVD does appear to decline substantially within the first 5 years, and smokers who are contemplating quitting may take some encouragement from this finding. On a population level, the implications of this study are sobering: reductions in CVD associated with declining smoking rates in countries such as Japan and the United States2 can be expected to lag quit rates by 10 to 15 years, and in countries where smoking rates appear to be increasing, such as China and Indonesia, rates of CVD are likely to increase for decades into the future. To counter these trends, all countries, particularly those most vulnerable to tobacco marketing, should implement tobacco control strategies to prevent smoking initiation and motivate current smokers to quit.

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Article Information

Corresponding Author: Thomas B. Cole, MD, MPH, 105 Misty Pines Pl, Carrboro, NC 27510 (tbcole@bellsouth.net).

Conflict of Interest Disclosures: None reported.

Duncan  MS, Freiberg  MS, Greevy  RA  Jr, Kundu  S, Vasan  RS, Tindle  HA.  Association of smoking cessation with subsequent risk of cardiovascular disease [published August 20, 2019].  JAMA. doi:10.1001/jama.2019.10298Google Scholar
Hoffman  SJ, Mammone  J, Rogers Van Katwyk  S,  et al.  Cigarette consumption estimates for 71 countries from 1970 to 2015: systematic collection of comparable data to facilitate quasi-experimental evaluations of national and global tobacco control interventions.  BMJ. 2019;365:l2231. doi:10.1136/bmj.l2231PubMedGoogle ScholarCrossref