Post-diagnostic smoking cessation and heart-disease mortality among adults smoking at cardiopulmonary disease diagnosis: An NHANES linked-mortality analysis.
Quitting smoking after cardiopulmonary disease diagnosis linked to lower heart-disease mortality
Post-diagnostic smoking cessation and heart-disease mortality among adults smoking at cardiopulmonary disease diagnosis: An NHANES linked-mortality analysis.
Population-based analyses usually classify smoking status at survey enrollment, which combines people who quit before disease recognition with those who continued smoking through diagnosis and quit afterward.
This study evaluated whether smoking cessation after a self-reported cardiopulmonary disease diagnosis was associated with subsequent all-cause and cause-specific mortality among adults reconstructed as smoking at diagnosis.
This secondary analysis pooled ten cross-sectional National Health and Nutrition Examination Survey (National Health and Nutrition Examination Survey) cycles from 1999-2000 through 2017-2018 and linked survey records to mortality follow-up through 2019.
quitting after diagnosis cut heart-disease death risk by about 40%
Among 2319 participants, 975 were post-diagnostic quitters, and 1344 were persistent smokers.
Associations with all-cause mortality (AHR=0.90; 95% CI: 0.74-1.09; p=0.276) and cancer mortality (AHR=0.72; 95% CI: 0.49-1.06; p=0.100) were not statistically significant.
Findings for heart-disease mortality were consistent across landmark, overlap-weighted, smoking-burden-adjusted, disease-restricted, quit-age reconstruction, and leave-one-covariate-out analyses.
Among adults retrospectively classified as smoking when cardiopulmonary disease was diagnosed, post-diagnostic cessation was associated with lower subsequent heart-disease mortality.
The findings are observational and remain susceptible to survivor selection, reverse causation, recall and social-desirability bias, exposure changes after enrollment, mortality misclassification, and residual confounding.