Association Between Smoking, Smoking Cessation, and Mortality by Race, Ethnicity, and Sex Among US Adults
Key result
Current smoking is linked to ~180% higher all-cause mortality, but quitting before 45 reduces excess risk.
- RR 2.80
- 95% CI 2.73-2.88
- n=551,388
Why the study?
Although smoking and cessation patterns vary across demographic groups in the US, there is limited evidence on whether smoking hazards and cessation benefits vary across these groups.
Does smoking cessation reduce mortality across different racial, ethnic, and sex groups compared to continued smoking?
Population
551 388 US adults aged 25 to 84 years at recruitment
Comparison
Current vs former vs never smoking across race, ethnicity, and sex
Design
Nationally representative prospective cohort study
Follow-up
Through December 31, 2019
Authors
Discussion
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Implication
Quitting before age 45 was associated with lower mortality across groups; extends prior evidence to diverse populations but leaves causality open.
Study Design
Type
Cohort (n=551,388)
Multicenter
Yes
Structured PICO
Does smoking cessation reduce mortality across different racial, ethnic, and sex groups compared to continued smoking?
P
Population
551,388 US adults aged 25 to 84 years at recruitment, mean age 48.9, 55.8% women, diverse racial and ethnic groups (15.8% Hispanic, 13.7% non-Hispanic Black, 64.5% non-Hispanic White, 6.0% other non-Hispanic).
I
Intervention
Current smoking and former smoking (including age at quitting and years since quitting)
C
Comparator
Never smoking
O
Outcome
All-cause mortality and mortality from cancer, cardiovascular disease, and lower respiratory diseasehard clinical
Main Result
Effect estimate: RR 2.80 (95% CI 2.73-2.88)
Current smoking doubles to triples mortality risk across all racial and ethnic groups, but quitting before age 45 eliminates the vast majority of this excess risk.
Cite This Study
Thomson et al. (2022) conducted a cohort in Smoking (n=551,388). Current smoking vs. Never smoking was evaluated on All-cause mortality (RR 2.80, 95% CI 2.73-2.88). Current smoking was associated with a higher all-cause mortality rate compared to never smoking (RR 2.80; 95% CI 2.73-2.88), and quitting before age 45 substantially reduced this excess risk.