Skip to main content
PMC home page
Japanese Journal of Cancer Research : Gann logoLink to Japanese Journal of Cancer Research : Gann
. 2001 Aug;92(8):821–828. doi: 10.1111/j.1349-7006.2001.tb01167.x

Decrease in Risk of Lung Cancer Death in Males after Smoking Cessation by Age at Quitting: Findings from the JACC Study

Kenji Wakai 1,✉, Nao Seki 3, Akiko Tamakoshi 1, Takaaki Kondo 2, Yoshikazu Nishino 4, Yoshinori Ito 5, Koji Suzuki 5, Kotaro Ozasa 6, Yoshiyuki Watanabe 6, Yoshiyuki Ohno 1; for the JACC Study Group†
PMCID: PMC5926829  PMID: 11509112

Abstract

To evaluate the impact of smoking cessation in individuals and populations, we examined the decrease in risk of lung cancer death in male ex‐smokers by age at quitting in the Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study), which was initiated from 1988 to 1990 in Japan. For simplicity, subjects were limited to male non‐smokers, and former/current smokers who started smoking at ages 18‐22, and 33 654 men aged 40‐79 years were included. We modeled the mortality rates in non‐smokers and current smokers, and compared the rates in ex‐smokers with those expected from the model if they had continued smoking. During the mean follow‐up of 8.0 years, 341 men died from lung cancer. The mortality rate ratio for current smokers, compared to non‐smokers, was 5.16, and those for ex‐smokers who had quit smoking 0‐4, 5‐9,10‐14,15‐19 and >20 years before were 4.84, 3.19, 2.03,1.29 and 0.99, respectively. The functions of 3.20×l0‐7×(age)45 and 1.96×lO‐5×(age‐29.6)4.5 fitted the observed mortality rates (per 100 000 person‐years) in non‐smokers and continuing smokers, respectively. A greater decrease in lung cancer mortality was estimated among those who quit smoking at younger ages. Stopping smoking earlier in life appears preferable to keep the individual risk low. The absolute rate, however, substantially decreased after smoking cessation even in those who quit at ages 60‐69, reflecting the high mortality rate among continuing smokers in the elderly.

Keywords: Lung cancer, Smoking cessation, Cohort study, Japan

Full Text

The Full Text of this article is available as a PDF (98.5 KB).

References

  • 1.The Surgeon General . Chapter 1: Introduction, overview, and conclusions . In “ The Health Benefits of Smoking Cessationed,” US Department of Health and Human Services , pp . 1 – 15 ( 1990. ). US Department of Health and Human Services; , Rockville , MD . [Google Scholar]
  • 2.Higgins , I. T. and Wynder , E. L . Reduction in risk of lung cancer among ex‐smokers with particular reference to histo‐logic type . Cancer , 62 , 2397 – 2401 ( 1988. ). [DOI] [PubMed] [Google Scholar]
  • 3.Sobue , T. , Suzuki , T. , Fujimoto , I. , Matsuda , M. , Doi , O. , Mori , T. , Furuse , K. , Fukuoka , M. , Yasumitsu , T. , Kuwahara , O. , Ichitani , M. , Taki , T. , Kuwabara , M. , Nakahara , K. , Endo , S. , Sawamura , K. , Kurata , M. and Hattori , S . Lung cancer risk among exsmokers . Jpn. J. Cancer Res. , 82 , 273 – 279 ( 1991. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 4.Gao , C. , Tajima , K. , Kuroishi , T. , Hirose , K. and Inoue , M . Protective effects of raw vegetables and fruit against lung canceramong smokers andex‐smokers: acase‐control study in the Tokai area of Japan . Jpn. J. Cancer Res. , 84 , 594 – 600 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 5.Hirayama , T. “ Life‐Styleand Mortality:ALarge‐Scale Census‐Based Cohort Study in Japan ,” pp . 1 – 138 ( 1990. ). Karger; , Basel . [Google Scholar]
  • 6.Sobue , T. , Yamaguchi , N. , Suzuki , T. , Fujimoto , I. , Matsuda , M. , Doi , O. , Mori , T. , Furuse , K. , Fukuoka , M. , Yasumitsu , T. , Kuwahara , O. , Ichitani , M. , Taki , T. , Kuwabara , M. , Nakahara , K. , Endo , S. , Sawamura , K. , Kurata , M. and Hattori , S . Lung cancer incidence rate for male ex‐smokers according to age at cessation of smoking . Jpn. J. Cancer Res. , 84 , 601 – 607 ( 1993. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 7.Mizuno , S. and Akiba , S . Smoking and lung cancer mortality in Japanese men: estimates for dose and duration of cigarette smoking based on the Japan Vital Statistics Data . Jpn. J. Cancer Res. , 80 , 727 – 731 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 8.Mizuno , S. , Akiba , S. and Hirayama , T . Lung cancer risk comparison among male smokers between the “Six‐prefecture Cohort” in Japan and the British Physicians' Cohort . Jpn. J. Cancer Res. , 80 , 1165 – 1170 ( 1989. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 9.Ohno , Y. , Tamakoshi , A . and the JACC StudyGroup. Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study) . J. Epide-miol. , 11 ( 2001. ), in press . [DOI] [PubMed] [Google Scholar]
  • 10.World Health Organization . “ International Statistical Classification of Diseases and Related Health Problems , 10th Rev. , Vol. 1 ,” pp . 1 – 1243 ( 1992. ). World Health Organization; , Geneva . [Google Scholar]
  • 11.Cox , D. R.Regression models and life‐tables (with discussions) . J. R. Stat. Soc. B , 34 , 187 – 220 ( 1972. ). [Google Scholar]
  • 12.Wakai , K. , Ohno , Y. , Watanabe , S. , Sakamoto , G. , Kasumi , F. , Suzuki , S. and Kubo‐Fujiwara , N.Risk factors for breast cancer among Japanese women in Tokyo: a case‐control study . J. Epidemiol. , 4 , 65 – 71 ( 1994. ). [Google Scholar]
  • 13.Bruemmer , B. , White , E. , Vaughan , T. L. and Cheney , C. L . Nutrient intake in relation to bladder cancer among middle‐aged men and women . Am. J. Epidemiol. , 144 , 485 – 495 ( 1996. ). [DOI] [PubMed] [Google Scholar]
  • 14.Doll , R. and Peto , R . Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non‐smokers . J. Epidemiol. Community Health , 32 , 303 – 313 ( 1978. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Lubin , J. H. and Blot , W. J . Lung cancer and smoking cessation: patterns of risk . J. Natl. Cancer Inst. , 85 , 422 – 423 ( 1993. ). [DOI] [PubMed] [Google Scholar]
  • 16.Haldorsen , T. and Grimsrud , T. K . Cohort analysis of cigarette smoking and lung cancer incidence among Norwegian women . Int. J. Epidemiol. , 28 , 1032 – 1036 ( 1999. ). [DOI] [PubMed] [Google Scholar]
  • 17.Peto , R.Influence of dose and duration of smoking on lung cancer rates . In “ Tobacco: A Major International Health Hazard ,” ed. Zaridze D. G. and Peto R. , pp . 23 – 33 ( 1986. ). IARC; , Lyon . [PubMed] [Google Scholar]
  • 18.Breslow , N. E. and Day , N. E.Fitting models to grouped data . In “ Statistical Methods in Cancer Research, Vol. 2. TheDesign and Analysis ofCohort Studies ,” ed. Heseltine E. , pp . 120 – 176 ( 1987. ). IARC; , Lyon . [Google Scholar]
  • 19.Pierce , D. A. and Preston , D. L.Hazard function modelling for dose‐response analysis of cancer incidence in the A‐bomb survivor data . In “ Atomic Bomb Survivor Data: Utilization and Analysis ,” ed. Prentice R. L. and Thompson D. J. , pp . 51 – 66 ( 1984. ). SIAM; , Philadelphia . [Google Scholar]
  • 20.Breslow , N. E. and Day , N. E.Modelling the relationship between risk, dose and time . In “ Statistical Methods in Cancer Research, Vol. 2. The Design and Analysis of Cohort Studies ,” ed. Heseltine E. , pp . 232 – 270 ( 1987. ). IARC; , Lyon . [Google Scholar]
  • 21.Tominaga , S.Smoking and cancer patterns and trends in Japan . In “ Tobacco: A Major International Health Hazard ,” ed Zaridze D. G. and Peto R. , pp . 103 – 113 ( 1986. ). IARC; , Lyon . [PubMed] [Google Scholar]
  • 22.Hymowitz , N. , Cummings , K. M. , Hyland , A. , Lynn , W. R. , Pechacek , T. F. and Hartwell , T. D.Predictors of smoking cessation in a cohort of adult smokers followed for five years . Tab. Control. , 6 ( Suppl. 2 ), S57 – S62 ( 1997. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 23.Doll , R. , Peto , R. , Wheatley , K. , Gray , R. and Sutherland , I . Mortality in relation to smoking: 40 years' observations on male British doctors . BMJ , 309 , 901 – 911 ( 1994. ). [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Halpern , M. T. , Gillespie , B. W. and Warner , K. E . Patterns of absolute risk of lung cancer mortality in former smokers . J. Natl. Cancer Inst. , 85 , 457 – 464 ( 1993. ). [DOI] [PubMed] [Google Scholar]

Articles from Japanese Journal of Cancer Research : Gann are provided here courtesy of Wiley

RESOURCES