Abstract 18263: Incident Heart Failure and All-Cause Mortality in Older Current Smokers and Former Smokers with 15 or More Years of Abstinence: Findings From a Prospective Population Study
Background: The 2004 Surgeon General's Report on “The Health Consequences of Smoking” suggests that after 15 years of abstinence, the cardiovascular (CV) risk of smoking becomes similar to that of never-smokers. At the AHA2010, we presented data that indicated that while that is true for most older former smokers, this benefit may not extend to older former heavy (≥32 pack-years) smokers. While the CV risk of former heavy smokers may take much longer than 15 years to become like that of never smokers, it is believed that the risk may be reduced compared to current smokers. In the current analysis, we compared the CV risk of older adults who quit smoking >15 years ago relative to older current smokers.
Methods: Of the 5795 community-dwelling older adults, age ≥65 years, in the public-use copy of the Cardiovascular Health Study data obtained from the NHLBI, 5604 had detailed data on current and past smoking. Of these, 5338 were free of prevalent HF at baseline. Of these, 629 were current smokers and 1298 were former smokers who quit >15 years ago, who were categorized as former heavy (≥32 pack-years; n=312) and former light (<32 pack-years; n=986) smokers.
Results: Patients had a mean (±SD) age of 73 (±5) years; 45% were women; and 14% were African American. Former heavy smokers were older and more likely to be white men (Table). Unadjusted, age-sex-race-adjusted and multivariable-adjusted risk of centrally-adjudicated incident HF and all-cause mortality associated with former light and heavy smoking relative to current smokers during over 13 years of follow-up are displayed in the Table.
Conclusions: Among community-dwelling older adults, compared with current smokers, former smokers who quit smoking >15 years ago had substantial and significant independent reduction in all-cause mortality regardless of amount and duration of smoking prior to cessation. However, the association with reduced risk of incident HF was only significant for older former light (<32 PY) smokers.
- © 2011 by American Heart Association, Inc.