Former smokers — who are at higher risk for poor health outcomes and premature death, compared with people who never smoked — can reduce these risks through various lifestyle factors, according to a new study published in the journal JAMA Network Open.
For people who smoke, the health benefits of quitting are clear, including for people with diabetes. This is the case even if it leads to weight gain, research shows. In fact, for people with heart disease, the benefits of quitting smoking are equivalent to taking multiple medications, according to a recent study. Smoking is also linked to worse blood glucose control in people with type 1 diabetes, so quitting may have glucose-lowering benefits.
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For the latest study, researchers looked at a group of 159,937 former smokers in the United States who initially completed lifestyle questionnaires in 1995 or 1996 and had their health outcomes tracked through 2019 at the latest — for an average follow-up period of 18.9 years. About 94% of participants were white, and their average age at the beginning of the study was 62.6.
During the follow-up period, 86,127 study participants died. Based on their earlier questionnaire responses, the researchers calculated how closely participants followed lifestyle recommendations in the areas of diet, physical activity, body weight, and alcohol intake — assigning them a total lifestyle score ranging from 0 (worst) to 8 (best). The researchers then looked at the relationship between lifestyle scores and dying during the follow-up period, adjusting for other factors known to affect the risk of dying earlier.
Healthier lifestyles linked to lower death risk
Compared with participants who had a lifestyle score of 0 to 2, those with a score of 3 or 4 were 12% less likely to die during the follow-up period. Those with a score of 5 or 6 were 20% less likely to die, and those with a score of 7 or 8 were 27% less likely to die. These links between lifestyle and death risk were seen regardless of participants’ overall health status, chronic health conditions, the number of cigarettes they used to smoke daily, how long since they quit smoking, and at what age they started smoking.
Compared with participants who had the lowest score in each lifestyle area, those with the highest score for diet were 9% less likely to die, those with the highest score for physical activity were 17% less likely to die, those with the highest score for body weight were 14% less likely to die, and those with the highest score for alcohol intake (meaning a lower intake of alcohol) were 4% less likely to die. Total lifestyle scores were linked not just to a lower risk of death from all causes, but also lower risks of dying from cancer, cardiovascular disease, or respiratory disease.
“These results provide evidence that former smokers may benefit from adhering to lifestyle recommendations, as do other groups,” the researchers concluded. Future studies on this topic, they wrote, should include a more diverse group of participants and evaluate their lifestyle habits throughout the follow-up period, including whether they started smoking again.
Want tips for kicking butts? Read “Quitting Smoking With Diabetes.”