Benefits of Quitting Smoking Cited : Health: Even older people with long history of tobacco use can extend their lives, surgeon general says. Insurers urged to pay for cessation programs.
WASHINGTON — After more than two decades of delivering grim statistics about the dangers of cigarettes, the annual surgeon general’s report on smoking released Tuesday brought some good news--it is never too late to quit.
“Smoking cessation has major and immediate health benefits for men and women of all ages,” Surgeon General Antonia C. Novello said at a press conference.
Even older Americans who have smoked for many years and those who suffer from smoking-related diseases and believe the damage has already been done can reverse some of smoking’s ill effects and extend their lives by stopping, said the report, which this year focused on the health benefits of giving up cigarettes.
Federal health officials, saying the investment is worth it, called on public and private insurers to pay for the cost of smoking cessation programs.
“While a great number of ex-smokers quit smoking on their own, this does not alter the need for special assistance on the part of some smokers,” said Dr. William Roper, director of the federal Centers for Disease Control. “And we believe the stakes are sufficiently high to try to see that they have that assistance.”
Although more than 38 million Americans have stopped smoking, about 50 million Americans smoked more than 500 billion cigarettes last year, Novello said. Smoking has been associated with certain cancers, especially lung cancer--the No. 1 cancer killer of men and women--and with circulatory diseases, heart disease, stroke and numerous respiratory diseases, including emphysema.
Federal health officials have estimated that the effects of smoking kill 390,000 Americans every year and cost the nation more than $52 billion in health care expenditures and lost productivity.
The report zeroed in on many of the public’s worst fears about the consequences of quitting, such as weight gain. A review of 15 studies involving 20,000 persons showed that--although four-fifths of the ex-smokers interviewed did gain weight--the average gain was only five pounds. The risk of large weight gain after quitting is extremely low, the report said.
“Less than 4% of those who quit smoking gained more than 20 pounds,” said Novello, who became the nation’s top doctor last March. “Sometimes, we should be more health conscious than body conscious--in this case, the time has come.”
A wide range of health organizations praised the report.
“There are immense benefits to quitting, no matter how long you’ve smoked,” said Fran Du Melle, chairman of the Coalition on Smoking OR Health, which represents the American Cancer Society, the American Heart Assn. and the American Lung Assn. “You’ll live longer . . . and you’ll feel better. That means you’ll be spending more time enjoying your family, friends and favorite activities.”
The Tobacco Institute said that the latest smoking report offered nothing new.
“Smokers have long had this universal awareness about what the surgeon general has to say about the health risks of smoking,” said Brennan Dawson, a spokeswoman for the industry group. “I don’t think today’s report gives them much new information in terms of making a decision about whether they want to continue smoking or whether or not they want to quit. People have been and will continue to be making choices about this.”
The report declared that “people who quit smoking live longer than those who continue to smoke,” adding that the extent to which premature death is reduced depends on the number of years of smoking, the number of cigarettes smoked per day and the presence or absence of disease at the time of quitting.
Nevertheless, the report said, people of all ages and at any point in their smoking history can benefit from stopping.
Novello said that federal health officials would start a campaign aimed at older Americans to encourage them to quit. Of the 50 million Americans who still smoke, an estimated 7 million are older than 60, she said.
“A healthy man aged 60 to 64 who smokes one pack of cigarettes or more per day reduces his risk of dying during the next 15 years by 10% if he quits smoking,” the report said.
Smokers who have already developed smoking-related disease or symptoms may be less motivated to quit because they believe the damage has already been done, and their physicians may be less likely to advise their patients to stop, the report said. But the evidence shows that stopping smoking can produce “important health benefits” even within this group, the report said.
For example, among persons with diagnosed coronary heart disease, quitting “markedly” reduces the risk of another heart attack and cardiovascular death, the report said. In many studies, this risk reduction has been 50% or more, the report said.
Even smokers who have already developed cancer may benefit from stopping, the report said. It cited several studies that have shown that persons who stopped smoking after a cancer diagnosis had a reduced risk of acquiring a second primary cancer compared with those who continued to smoke.
The CDC’s Roper, who served as director of the Health Care Financing Administration during the Ronald Reagan Administration, said that states already have the option of extending coverage for cessation programs under Medicaid. Coverage under Medicare, the federal assistance program for the elderly, probably would require congressional action, he said. Roper predicted that “Congress will look favorably on it.”
Roper singled out King County Medical/Blue Shield in Washington state for a program that reimburses physicians and psychologists for helping patients to quit smoking. “We would hope that other insurance companies would follow that example,” he said.
BENEFITS OF QUITTING Risk of dying within the next 15 years for Americans aged 55 to 59: Smokers Men: 46% Women: 27% Ex-smokers Men: 33% Women: 15% Lifetime non-smokers Men: 18% Women: 11% Source: American Cancer Society
