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Smoking cessation improves mortality in Japanese men: the Hisayama study
  1. Fumie Ikeda1,2,
  2. Toshiharu Ninomiya1,2,
  3. Yasufumi Doi1,2,
  4. Jun Hata1,2,
  5. Masayo Fukuhara1,2,
  6. Takayuki Matsumoto2,
  7. Yutaka Kiyohara1
  1. 1Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  2. 2Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Correspondence to Dr Fumie Ikeda, Department of Environmental Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka City 812-8582, Japan; fumikeda{at}


Background Although the smoking rate among Japanese men has been the highest in developed countries, the epidemiological evidence about whether smoking cessation can extend their lifespan is not well established.

Methods A total of 1083 Japanese men aged ≥40 years were classified by their smoking status and followed up prospectively for 18 years (1988–2006).

Results Current smoking was a significant risk factor for all-cause death: the multivariate-adjusted HRs of all-cause death for current smokers of 1–19, 20–39 and ≥40 cigarettes per day were 1.61 (95% CI 1.16 to 2.22), 1.56 (95% CI 1.08 to 2.23) and 3.15 (95% CI 1.59 to 6.24), respectively. Former smokers did not have an increased risk of all-cause death compared with never smokers. The excess risk of all-cause death for current smokers tended to decrease within 5 years after smoking cessation, eventually reaching a level almost equivalent to that of never smokers. The risk of cancer death decreased by 53% in subjects who had quit smoking for ≥10 years, while the risk of cardiovascular death decreased by 56% in subjects with the cessation period of <10 years.

Conclusions Our findings suggest that even a modest smoking habit significantly increases the risk of death among Japanese men, and the risk of death diminishes soon after cessation of smoking. These results imply the importance of smoking cessation to extend life in Japanese men.

  • Smoking
  • smoking cessation
  • mortality
  • cancer
  • cardiovascular diseases
  • cessation
  • smoking caused disease

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  • Funding This work was supported in part by Grants-in-Aid for Scientific Research A (No 18209024) and C (No 20591063) from the Ministry of Education, Culture, Sports, Science and Technology of Japan, a Health and Labour Sciences Research Grant of the Ministry of Health, Labour and Welfare of Japan (Comprehensive Research on Ageing and Health: H20-Chouju-004) and Fukuoka Foundation For Sound Health.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of the Kyushu University.

  • Provenance and peer review Not commissioned; externally peer reviewed.