Among heavy smokers, smoking cessation is associated with significantly lower risk of cardiovascular disease within 5 years of cessation relative to current smokers. However, relative to never smokers, former smokers' cardiovascular disease risk remains significantly elevated beyond 5 years after smoking cessation, according to a study published Aug. 20 in the Journal of the American Medical Association.

Meredith S. Duncan, MA, et al., conducted a retrospective analysis of 8,770 individuals from the Framingham Heart Study. Among the individuals, there were 5,308 former or current smokers with a median 17.2 baseline pack-years, including 2,371 heavy smokers, defined as ≥20 pack-years.

Results showed that over 26.4 median follow-up years, 2,435 first cardiovascular disease events occurred. In addition, compared with current smoking, quitting within 5 years was associated with significantly lower rates of incident cardiovascular disease. Whereas, compared with never smoking, quitting was associated with greater cardiovascular risk between 10 and 15 years after cessation.

The authors conclude that their study reaffirms the cardiovascular benefit of smoking cessation, but also reveals "a slow ensuing cardiovascular disease risk decline over decades."

In a related editorial comment, Thomas B. Cole, MD, MPH, notes that "On a population level, the implications of this study are sobering: reductions in cardiovascular disease associated with declining smoking rates in countries such as Japan and the U.S. can be expected to lag quit rates by 10 to 15 years, and in countries where smoking rates appear to be increasing, such as China and Indonesia, rates of cardiovascular disease are likely to increase for decades into the future."

Keywords: Smoking Cessation, Japan, Retrospective Studies, Cardiovascular Diseases, Indonesia, American Medical Association, Smoking, China

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