What's new in the other general journalsBMJ 2005; 331 doi: http://dx.doi.org/10.1136/bmj.331.7520.801 (Published 06 October 2005) Cite this as: BMJ 2005;331:801
- Alison Tonks, associate editor ([email protected])
Heavy smokers who cut down may reduce their risk of lung cancer
Giving up smoking is one certain way of protecting yourself against lung cancer. Everyone knows it, but so few smokers manage to do it. For the majority of smokers who can't or won't stop, cutting down the number of cigarettes they smoke each day may help.
In a large cohort study from Denmark, heavy smokers (≥ 15 cigarettes/day) who managed to cut down by at least half were 27% less likely to get lung cancer over the next 18 years or so, than those who continued smoking heavily (hazard ratio 0.73, 95% CI 0.54 to 0.98). Light smokers (< 15 cigarettes/day) were 56% less likely to get lung cancer than heavy smokers, and former smokers who had quit before the study began reduced their risk by 83%. Predictably, Danes who had never smoked had the lowest risk of all—91% lower than the heavy smokers (0.09, 0.06 to 0.13).
So, although giving up for good is best, doctors can at least tell hard core smokers that cutting down is better than nothing. Unfortunately, there's no evidence that cutting down protects anyone against heart disease or chronic obstructive pulmonary disease, both of which have a greater impact than lung cancer on public health.
JAMA 2005;294: 1505-10
Statins: those benefits in detail
A detailed analysis of who benefits from statins and by how much reports that each 1 mmol/l drop in serum concentration of low density lipoprotein cholesterol reduces overall mortality by 12% over five years. It also reduces risk of coronary death or heart attack by 23%, need for coronary vascularisation by 24%, risk of stroke (fatal or non-fatal) by 17%, and risk of any major vascular event by 21%.
The benefits seem largely independent of age, sex, pre-existing disease, or baseline serum concentration of LDL cholesterol. Statins work even for people with LDL cholesterol …
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