Death risk charts put smoking harm in perspective

NEW YORK (Reuters Health) - Smoking shortens a person's life by 5 to 10 years, according to the authors of a set of simple charts spelling out death risks from various causes.

For example, 55 year old men who smoke have the same risk of dying from any cause as 65 year old men who have never smoked.

"We hope that the availability of these simple charts will facilitate physician-patient discussion about disease risk and help people understand where to focus risk reduction efforts," Dr. Steven Woloshin of the VA Medical Center in White River Junction, Vermont and colleagues report.

The charts, initially published in 2002, have been updated with the latest US mortality data, and are published in the Journal of the National Cancer Institute. The risks of former and current smokers are now in separate categories.

Information on health risks often lacks context, making it difficult for a person to understand his or her actual probability of death from a particular cause, Woloshin and his team note. "Useful messages about health risks should address two questions: how big is my risk and how does this risk compare with other risks?"

With this goal in mind, Woloshin and his team have developed charts that calculate the risk of dying within the next 10 years of various causes based on age, sex and smoking status.

For men and women the researchers developed two charts: one including expected deaths per 1000 for never-smokers and non-smokers from vascular disease, cancer, infection, lung disease or accidents in 5-year increments from age 35 to 75, and another chart providing the same information for ex-smokers.

The charts show that accidents are the leading killer of men who have never smoked and are younger than 45 years. After 45 years, these men are just as likely to die of heart disease; heart disease outpaces all other causes of death for males 50 and older.

However, male smokers are more likely to die of heart disease than any other cause up until age 60; after that, lung cancer becomes the leading cause of mortality in this group.

Among women who smoke and are 40 years old or older, the risk of dying from lung cancer or heart disease is greater than mortality from breast cancer, the charts show. Mortality risk for a 55-year-old woman who smokes is between that for 60- and 65-year-old non-smokers.

The charts are a step in the right direction toward communicating risk effectively, Dr. Michael J. Thun and colleagues from the American Cancer Society in Atlanta and colleagues note in an editorial accompanying the study. But they argue that numbers alone aren't enough to communicate risk effectively. More individualized communication strategies, delivered interactively, would have a greater impact, they say.

SOURCE: Journal of the National Cancer Institute, June 18, 2008.