The objective of this study was to assess the risk of dying associated
with smoking after the age of 65 years and the benefits of quitting s
moking, taking into account baseline health status. The study was carr
ied out in Barcelona, Spain, a southern European city with an increase
in smoking prevalence and lifestyle different from those of other are
as where hazards of smoking have been studied. A follow-up study begun
in 1986 was carried out in 477 males (94.3% of the original cohort) w
ho were randomly selected by census from members of the Barcelona gene
ral population aged greater than or equal to 65 years, Vital status as
of October 1994 and, where applicable, cause of death (cardiovascular
disease, cancer, or respiratory disease) were assessed. The relative
risk of dying was 2.11 (95% confidence interval (CI) 1.37-3.26) times
higher in current smokers and 1.53 (95% CI 1.03-2.27) times higher in
former smokers than in never smokers. Quitting smoking after the age o
f 65 years reduced the relative risk of dying to 0.77 (95 % CI 0.51-1.
16) in comparison with continuing to smoke, although persons who stopp
ed smoking had poorer self-perceived health and were more frequently r
eported to suffer from cardiovascular disease (p < 0.05). This study c
onfirms that the effects of smoking extend to later life in this elder
ly general population, with a magnitude as great as that seen in previ
ous studies with different populations. In addition, it indicates that
stopping smoking after age 65 reduces the risk of dying.