Ex-smokers cut risk of dying early by adopting healthy behaviors, study says

WASHINGTON, Sept. 22 (UPI) -- The 52 million former smokers in the United States should stick to a healthy lifestyle to reduce their risk of dying early, a federal study published Thursday urges.

Researchers from the National Cancer Institute, a part of the National Institutes of Health, said a lower risk of dying was observed for cancer, heart disease and lung disease and other maladies.

Adhering to scientific evidence-based recommendations to maintain a healthy body weight, stay physically active, eat a healthy diet and limit alcohol consumption was associated with a 27% reduction in the risk of death for former smokers over the study's 19-year follow-up period, compared with those who don't follow a healthy lifestyle.

The findings were published in JAMA Network Open.

The bottom line is that former smokers benefit from quitting smoking and would benefit even more if they adhere to other aspects of a healthy lifestyle, Maki Inoue-Choi, the paper's lead author, told UPI in an email.

Former smokers still have a higher risk of disease and premature death than people who have never smoked, noted Inoue-Choi, an epidemiologist in NCI's Division of Cancer Epidemiology & Genetics.

Inoue-Choi said it was important to determine if people who quit smoking can further reduce their risk of death by adopting other healthy lifestyle recommendations. And, she said, the study's results suggest this can happen.

To have the greatest benefit, it is better to adhere to many lifestyle recommendations, Inoue-Choi said. But even former smokers who adopted a single lifestyle recommendation experienced benefits.

In fact, she said, she was surprised to see the robust associations with lifestyle.

The new analysis involved about 160,000 former smokers who participated in the NIH-AARP Diet and Health Study. They had completed questionnaires about lifestyle, demographics and other health-related information when they joined the study between 1995 and 1996.

The participants averaged 62 years old when the study began. Over its course, 86,127 of them died and the investigators retrieved death information, including the cause of death, from the National Death Index.

The researchers calculated a total adherence score for each participant, ranging from no adherence to full adherence, incorporating World Health Organization guidelines, Physical Activity Guidelines for Americans and Dietary Guidelines for Americans.

Former smokers with the highest healthy lifestyle adherence scores saw a 24% drop in risk of death from cancer, 28% from cardiovascular disease and 30% from respiratory disease.

The scientists said the reductions in risk of death were observed regardless of the person's health status, other health conditions, how many cigarettes they previously smoked per day, the years since they quit and the age when they began smoking.

"We found evidence that all former smokers would benefit from adhering to healthy lifestyle recommendations ... regardless of how much they had smoked per day or how long ago they had quit smoking," Inoue-Choi said.

"The key message for public health is that all former smokers may additionally benefit from adhering to healthy lifestyle recommendations, regardless of their prior smoking use," she said.