Associations of Major Disease Diagnoses (Myocardial Infarction, Stroke, and Cancer) and Surgery with Smoking Cessation: A population-based cohort study in Japan.

Background

Smoking increases the risk of cancer and cardiovascular disease, and cessation after diagnosis improves prognosis. However, long-term associations of disease diagnoses and surgery with smoking cessation remain unclear. We evaluated associations of major disease diagnoses (myocardial infarction, stroke, and cancer) and surgery with smoking cessation at the 10-year follow-up among adults who smoked at baseline.

Methods

This prospective cohort study followed 17,779 participants aged 40-69 years who current smoking at baseline in the Japan Public Health Center-based Prospective Study for 10 years. Participants had no history of major diseases or surgery at baseline. Smoking status was assessed at baseline and 10-year follow-up. Incident myocardial infarction, stroke, and cancer were ascertained from questionnaire-reported diagnosis timing and population-based registries. Surgeries were identified from self-administered questionnaires. Multivariable logistic regression with multiple imputation estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the association between incident disease diagnoses or surgeries and smoking cessation.

Results

During follow-up, 4,789 participants (26.9%) quit smoking. Any major disease diagnosis (N = 1,726) was associated with cessation compared with no diagnosis (OR 5.39, 95% CI 4.80-6.05), including myocardial infarction (OR 6.87, 95% CI 5.18-9.12), stroke (OR 4.03, 95% CI 3.40-4.78) and cancer (OR 2.91, 95% CI 2.53-3.34). Lung cancer (OR 7.41, 95% CI 4.44-12.51) and lung surgery (OR 16.60, 95% CI 9.08-30.36) showed strong associations.

Conclusions

Major disease diagnoses and surgery were strongly associated with long-term smoking cessation over 10 years. These events may provide potential "teachable moments" for health professionals to encourage cessation.