Even longtime smokers benefit from quitting

On Call

August 27, 1996|By Dr. Simeon Margolis | Dr. Simeon Margolis,SPECIAL TO THE SUN

My husband has smoked more than a pack of cigarettes a day for over 25 years. Based on a recent examination, his doctor said that he has early signs of lung disease. I have tried to get my husband to stop smoking, but he feels it is not worth the effort because the damage is already done. Is it too late for him to benefit?

Not at all.

In 1994 the Lung Health Study completed a five-year evaluation of the effects of smoking cessation in 5,887 men and women from the United States and Canada, aged 35 to 60, who had evidence of mild chronic obstructive pulmonary disease (COPD). COPD includes asthma, emphysema (loss of elasticity of the lungs), and chronic bronchitis, although few had prior symptoms of asthma. Subjects were randomly assigned to either an intensive smoking cessation program or usual care with no special effort to encourage smoking cessation.

The results of this study showed that the damage caused by smoking is at least partly reversible. Lung function improved promptly and then stabilized in those who stopped smoking, while lung function continued to worsen in those who still smoked. The benefits were greater in women than in men. Like your husband, the participants in this study only had mild lung damage; it is uncertain whether those with more severe COPD would have similar benefits.

COPD was the fourth leading cause of death among both men and women in this country in 1991. The number of deaths from COPD has continued to increase while deaths from other causes have fallen or stayed the same. Formerly considered mainly a disease of men, the incidence of COPD has risen steadily among women. Early symptoms of COPD include mild shortness of breath on exertion and chronic cough. A common symptom of COPD among those in this study was the onset of wheezing when they developed a cold.

Your husband should realize that half of all smokers die prematurely of some disease related to cigarette smoking. In addition to benefiting lung function, smoking cessation leads to a gradual but dramatic reduction in lung cancer and lowers the risk of heart attacks to that of nonsmokers after five years or less. The bottom line, apparently, is that it is never too late to stop smoking.

Your husband should also know that smoking cessation programs work. The Lung Health Study found that after five years, 22 percent of those in the intensive program had stopped smoking, compared with 5 percent in the usual care group.

The researchers noted that long-term use of nicotine gum had no adverse effects and helped to keep subjects from restarting their smoking habit. Smoking cessation was assessed by the subjects' reports and validated by two biochemical measurements. It is interesting that one out of eight subjects falsely reported that they had stopped smoking even when they knew their responses were checked by biochemical tests.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

Pub Date: 8/27/96

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