MONDAY, March 4, 2002 (HealthDayNews) -- Quitting smoking is hard, there's no doubt about it. However, if you can tough it out for at least two years, chances are good you'll never light another cigarette again.
That's the conclusion of a new study that appears in the March issue of Nicotine and Tobacco Research. Health experts found two years after quitting smoking, only 2 percent to 4 percent of ex-smokers picked up the habit again each year.
"Once [ex-smokers] got past 10 years, relapse rates fell to very low amounts, less than 1 percent," says study author Elizabeth Krall, an associate professor of health policy and health services at Boston University's School of Dental Medicine.
Smoking-related diseases kill 430,000 Americans every year, according to the American Lung Association. Smoking also causes 87 percent of all lung cancer cases, and the cost of health care and lost productivity from smoking is close to $100 billion annually.
The benefits of quitting are clear. Just 20 minutes after your last cigarette, your blood pressure and heart rate start to return to normal. After only a day, the risk of a heart attack begins to diminish, the lung association says.
However, those who reap the most benefits are those who stay off cigarettes long-term. Fifteen years after the last puff, an ex-smoker's rate of heart disease and cancer is close to that of someone who never smoked.
Despite the health risks, almost 47 million Americans still smoke, according to the Centers for Disease Control and Prevention (CDC).
Every year, about 40 percent of smokers try to kick the habit, says Ron Todd, director of tobacco control for the American Cancer Society.
Krall and her colleagues studied data from an ongoing aging study that began in 1960. More than 2,200 men were enrolled in the study, and most were veterans. From that group, the researchers identified 483 men who had reported quitting smoking.
On average, the men who quit smoking had started smoking in their late teens, smoked for more than 30 years, and smoked a pack-and-a-half a day.
Krall says other studies have found first-year relapse rates to be very high, as much as 60 percent to 90 percent. Other research suggests that during the second year of quitting, relapse rates are around 15 percent. Because the men Krall and her colleagues studied were only seen every three years, it was impossible to gather accurate information about first- and second-year relapse rates, she says.
Smokers trying to quit are most likely to relapse in the first few days, says Todd, because that's when withdrawal symptoms are strongest. It takes about four to six weeks to get over most of the symptoms, he adds.
Those who were able to stay off cigarettes for more than two years dramatically increased their chances of staying off for good, the study found. Between the second and sixth year of quitting, only 2 percent to 4 percent of smokers went back to cigarettes each year. Those who stayed off for 10 years or more had the biggest success rates; less than 1 percent went back to smoking annually.
Overall, only 19 percent of the men who had stayed off cigarettes for two years or more resumed smoking. The biggest reason cited for smoking again was feeling nervous or tense. Other reasons cited included missing the pleasure of smoking, feeling pressured by family members or friends who smoked, or feeling addicted so they couldn't stop.
The researchers also discovered men who drank more than five alcoholic drinks a day were more likely to relapse. Another factor that appeared to influence relapse was drinking more than six cups of coffee daily.
Todd says he's not surprised by the study's findings. He adds that when you're quitting something addictive, like nicotine, it's important to find behaviors to replace that activity.
"The longer you abstain from smoking, the better you become at finding new things to replace that behavior," Todd says.
What To Do
Most people try to quit smoking five to seven times before they're successful, Todd says. Smokers need to be aware they're making a long-term commitment and the longer they can stay off cigarettes, the better their chances for success. You must have confidence in your ability to quit, and nicotine-replacement products can be very helpful, he adds.
"I'm not aware of any other single act that can benefit your health more than quitting smoking can," Todd says.
The American Lung Association explains the health benefits of quitting smoking. Here are some tips on kicking the habit from QuitNet and the CDC.
