02-001 · EVIDENCE A · SOURCE-SENSITIVE
Quitting smoking, the earlier the better
戒烟,越早越好
It costs nothing — in fact, it saves money. A pack-a-day habit costs roughly $3–$4, which you’ll no longer spend after quitting. The hard part is getting through the withdrawal period, which usually lasts a few weeks to several months.
On average, smokers live more than 10 years less than non-smokers. Quitting before age 40 eliminates roughly 90% of the extra death risk caused by continued smoking. The earlier you quit, the more years you gain.
A
Move “Quitting smoking, the earlier the better” to Future Me's calendar
The excuse
One more exception feels free because the bill arrives outside the current scene.
What feels good now
Today I keep a few minutes, a bit of persistence and avoid interrupting my default routine.
What the source says
The source summarizes the return this way: “On average, smokers live more than 10 years less than non-smokers. Quitting before age 40 eliminates roughly 90% of the extra death risk caused by continued smoking. The earlier you quit, the more years you gain.” Evidence grade A. The original states the population, caveats, and sources; this is not a personal forecast.
Use the original facts and limits. For an urgent medical, safety, financial, or legal issue, contact a qualified local professional or service.
THE ENGLISH EDITION
Original recommendation and evidence
1. Quitting smoking, the earlier the better
Cost: It costs nothing — in fact, it saves money. A pack-a-day habit costs roughly $3–$4, which you’ll no longer spend after quitting. The hard part is getting through the withdrawal period, which usually lasts a few weeks to several months.
In plain terms: On average, smokers live more than 10 years less than non-smokers. Quitting before age 40 eliminates roughly 90% of the extra death risk caused by continued smoking. The earlier you quit, the more years you gain.
Benefit: One U.S. study that tracked participants without assigning them to groups found that current smokers have a life expectancy more than 10 years shorter than those who never smoked. Quitting before age 40 removes about 90% of this excess mortality risk. Quitting between ages 25–34 adds roughly 10 years to life expectancy; between 35–44, about 9 years; and between 45–54, about 6 years (as reported in the original source). Similar Chinese research from the 2010s shows that urban male smokers have a 1.65 times higher death risk than non-smokers (RR 1.65), while rural male smokers have a 1.22 times higher risk. After 10 years of sustained abstinence, this smoking-related risk nearly disappears.
Evidence grade: A
Sources: Jha P et al. (2013). 21st-century hazards of smoking and benefits of cessation in the United States. NEJM. <https://doi.org/10.1056/NEJMsa1211128>; Chen Z et al. (2015). Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. <https://doi.org/10.1016/S0140-6736(15)00340-2>; Oberg M et al. (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. <https://doi.org/10.1016/S0140-6736(10)61388-8> (The two numbers of secondhand smoke)
Notes: Secondhand smoke is deadly too: in 2004, an estimated 603,000 people worldwide died from exposure to it, accounting for roughly 1% of all global deaths that year. Even if you don’t smoke yourself, you must avoid secondhand smoke, especially to protect children. Specific quitting strategies are outlined in the following sections: Section 3 (smoking cessation medications), Section 4 (setting a quit date), Section 5 (visiting a smoking cessation clinic), and Section 6 (e-cigarettes).
Source links
- Jha P 等 (2013). 21st-century hazards of smoking and benefits of cessation in the United States. NEJM. ↗
- Chen Z 等 (2015). Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. ↗
- Oberg M 等 (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. ↗
- Scolaro JA 等 (2014). Cigarette smoking increases complications following fracture: a systematic review. J Bone Joint Surg Am. ↗
- Nåsell H 等 (2010). Effect of smoking cessation intervention on results of acute fracture surgery: a randomized controlled trial. J Bone Joint Surg Am. ↗
- Thomsen T 等 (2014). Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. ↗
- Pinned original chapter on GitHub ↗
Read the complete Chinese source and notes
1. 戒烟,越早越好
成本: 不花钱,反过来还省钱。一天一包烟约 20–30 元,戒了这笔钱就留下了。难在戒断期要熬,一般是几周到几个月。
说人话: 吸烟的人平均比不吸烟的人少活十年以上。40 岁前戒掉,能把接着吸烟带来的死亡风险抹掉九成左右。戒得越早,捡回来的越多。骨折以后接着抽,骨头长不上的几率约是不抽的 2.3 倍,所以骨头没长好之前别抽。
收益: 美国一项跟踪一群人的研究(只记录、不分组)发现:现在还吸烟的人,比从不吸烟的人预期寿命短 10 年以上。40 岁前戒掉,可以消除继续吸烟所带来死亡风险的约 90%。25–34 岁戒烟约多活 10 年,35–44 岁约多活 9 年,45–54 岁约多活 6 年(原文以寿命年报告)。中国的同类研究:2010 年代,城市男性吸烟者的死亡风险是不吸烟者的 1.65 倍(RR 1.65),农村男性是 1.22 倍。主动戒烟满 10 年后,吸烟带来的这部分风险接近消失。骨折之后也一样。19 项只记录、不分组的研究合起来算,吸烟的人骨折不愈合(骨头长不上)的几率约是不吸烟者的 2.3 倍(OR 2.32,95% CI 1.76–3.06,已扣除其他因素)。小腿胫骨骨折和开放性骨折里同样偏高。瑞典一项随机试验里,骨折急诊手术后参加 6 周戒烟项目的 50 人,20% 出现至少一种术后并发症。没参加的 55 人是 38%。提前约好的手术,可以在术前 4 到 8 周开始戒烟,每周有人辅导,配尼古丁替代品。这样做术后并发症低约 58%(RR 0.42,95% CI 0.27–0.65,2 项试验、210 人)。
证据等级: A
来源: Jha P 等 (2013). 21st-century hazards of smoking and benefits of cessation in the United States. NEJM. <https://doi.org/10.1056/NEJMsa1211128>;Chen Z 等 (2015). Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet. <https://doi.org/10.1016/S0140-6736(15)00340-2>;Oberg M 等 (2011). Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet. <https://doi.org/10.1016/S0140-6736(10)61388-8>(二手烟那两个数字);Scolaro JA 等 (2014). Cigarette smoking increases complications following fracture: a systematic review. J Bone Joint Surg Am. <https://doi.org/10.2106/JBJS.M.00081>;Nåsell H 等 (2010). Effect of smoking cessation intervention on results of acute fracture surgery: a randomized controlled trial. J Bone Joint Surg Am. <https://doi.org/10.2106/JBJS.I.00627>;Thomsen T 等 (2014). Interventions for preoperative smoking cessation. Cochrane Database Syst Rev. <https://doi.org/10.1002/14651858.CD002294.pub4>(骨折和手术那几个数字)
备注: 吸别人的烟同样会死人:2004 年全球约有 60.3 万人死于二手烟,占当年全球总死亡的约 1%。自己不吸,也要躲开别人的烟,尤其别让孩子吸到。怎么戒,具体办法在后面四条:第 3 条(戒烟药)、第 4 条(定一个戒烟日)、第 5 条(去戒烟门诊)、第 6 条(电子烟)。骨不愈合那个数字来自只记录、不分组的研究,吸烟的人在别的方面也可能和不吸烟的人不同,没法全部扣干净。骨折后那项戒烟试验只有 105 人,换一种算法差别就不显著。
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