Abstention from smoking extends life and compresses morbidity: a population based study of health expectancy among smokers and never smokers in Denmark

Objective-To estimate health expectancy that is, the average lifetime in go od health-among never smokers, ex-smokers, and smokers in Denmark. Design-A method suggested by Peto and colleagues in 1992 for estimating smo king attributable mortality rates was used to construct a life table for ne ver smokers. This life table and relative risks for death for ex-smokers an d smokers versus never smokers were used to estimate life tables for ex-smo kers and smokers. Life tables and prevalence rates of health status were co mbined and health expectancy was calculated by Sullivan's method. Setting The Danish adult population. Main outcome measures-The expected lifetime in self rated good health or wi thout longstanding illness for never smokers and smokers. Results-The expected lifetime of a 20 year old man who will never begin to smoke is 56.7 years, 48.7 (95% confidence interval (Cl), 46.8 to 50.7) year s of which are expected to be in self rated good health. The corresponding figures for a man who smokes heavily are 49.5 years, 36.5 (95% Cl 35.0 to 3 8.1) years of which are in self rated good health. A 20 year old woman who will never begin to smoke can expect to live a further 60.9 years, with 46. 4 (95% Cl 44.9 to 47.8) years in self rated good health; if she is a lifelo ng heavy smoker, her expected lifetime is reduced to 53.8 years, 33.8 (95% Cl 31.7 to 35.9) years of which are in self rated good health. Health expec tancy based on long standing illness is reduced for smokers when compared w ith never smokers. Conclusions-Smoking reduces the expected lifetime in good health and increa ses the expected lifetime in poor health.