Researchers who investigated the health and lifestyle habits of 54,000 Norwegians 30 years after recruiting them on a study found that the non-smokers lived longer and had better cardiovascular health than the smokers. They concluded that smoking is “strongly” linked to death and cardiovascular disease.

The study was the work of Professor Haakon Meyer from the University of Oslo and Norwegian Institute of Public Health and colleagues and is being presented this week at the EuroPRevent 2009 conference which is taking place in Stockholm, Sweden from 6th to 9th May.

The conference is organized by The European Association for Cardiovascular Prevention and Rehabilitation (EACPR), a Registered Branch of the European Society of Cardiology.

Cardiovascular disease is the main cause of death in Europe where it kills more than 2 million people a year. Many of these deaths could be prevented say health experts, if prevention policies were adopted and fully implemented.

Meyer said their findings confirm those of many other studies, but in particular they show the absolute, long-term “real life” risk of smoking.

He and his colleagues started the study in 1974 when they invited every man and woman aged from 35 to 49 living in three counties in Norway to take part in a cardiovascular screening exam. The response was huge and over 90 per cent of those invited attended the baseline screening.

For the next 30 years the researchers tracked deaths among the participants by looking at the Norwegian population registry, and from 2006 to 2008 they asked the survivors to complete a questionnaire that included questions about their smoking habits and their health and disease incidents.

From the responses Meyer and colleagues were able to group the participants as never-smokers, ex-smokers, current smokers of 1 to 9 cigarettes and day, current smokers of 10 to 19 a day, and current smokers of more than 20 a day. Those smoking more than 20 a day were classed as “heavy smokers”.

The results showed that:

  • By the time of follow up, 13,103 (24 per cent) of the original 54,075 participants had died.
  • 45 per cent of the heavy-smoking men had died over the 30 years of the study compared to only 18 per cent of the never-smoking men.
  • And 33 per cent of the heavy-smoking women had died compared to 13 of the never-smoking women.
  • The cumulative incidence of heart attack (myocardial infarction, MI) was 21 per cent in the heavy smoking men and 10 per cent in the never-smoking men.
  • The figures for women were 11 per cent in the heavy smokers and 4 per cent in the never smokers.
  • Strong links were also found between smoking and stroke and diabetes.

Meyer said that:

“These results show what a tremendous impact smoking has on mortality.”

“We are talking about very high numbers of people,” he added, explaining that the analysis highlights the cumulative long term link between smoking, death and cardiovascular disease.

About two thirds of middle-aged male heavy smokers and half the middle-aged female heavy smokers had either died or had cardivascular disease over the 30 year follow up. There was a substantial difference in outcome between the never-smokers and heavy smokers.

“This study underlines the public health messages about smoking,” said Meyer.

While smoking appears to be declining in developed countries, some important challenges still remain, he said, with certain groups like young women, and immigrant communities still showing high rates of smoking. More needs to be done for those groups he said.

“Morbidity and mortality among smokers and non-smokers – 30 years follow-up of 54,000 middle-aged Norwegian women and men.”
Haakon Meyer, 7 May 2009, 15.30-16.30, Poster area.
EuroPRevent 2009, Stockholm, Sweden, 6-9 May.

Source: European Society of Cardiology.

Written by: Catharine Paddock, PhD