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“Quick Wins”: the short-term benefits of stopping smoking


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This briefing summarises evidence on the benefits of smoking cessation, focusing on gains within the first year of stopping smoking.
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This briefing summarises evidence on the benefits of smoking cessation, focusing on gains within
the first year of stopping smoking.
The largest health gain in the first year is a 50% reduction in excess risk of fatal and non-fatal
heart attack in those who are 35+ years old. This represents 14 premature deaths prevented
for every 1,000 middle aged or older smokers who stop
For those suffering from chronic obstructive pulmonary disease (COPD) there are fewer hospital
admissions and deaths because of a reduction in acute episodes known as ‘exacerbations’
Within three months there is improvement in overall lung function in people with mild to
moderate COPD
Erectile dysfunction reduces within one month
There is a reduction in periodontal disease within one year
In smokers undergoing surgery, wound healing is improved and risk of post-operative
complications reduced
In pregnant smokers, risk of low birth weight reduces, and risk of pre-term birth, spontaneous
abortion, maternal and perinatal death decreases
Facial appearance (pallor and wrinkles) improves within one month
Improved sense of taste and smell occurs within 12 months
Overall life satisfaction increases within one year
Anxiety and depression levels decrease within three to six months
Ex-smokers save an average of £1,300 in the first year on the cost of cigarettes
Quick wins: the short-term benefits
of stopping smoking
© 2013 National Centre for Smoking Cessation and Training (NCSCT)
Author: Lion Shahab
Editor: Andy McEwen
Reviewers: Susan Michie and Robert West
Briefing: 12
1. Background
Stopping smoking improves healthy life expectancy by an average of six hours for each day of
smoking prevented after early middle age,1 up to approximately 10 years in both men and women
if they stop smoking in their 30s.
For most smokers this benefit does not accrue until later in life. Many smokers and public bodies
for whom smoking represents a financial cost are interested in knowing what benefits can be
expected much sooner than that. This briefing summarises evidence on benefits that can be
expected within the first year of stopping.
2. Methods
Electronic research databases (PubMed, Web of Science and Google Scholar) were reviewed
using the terms ”benefit”, “advantage”, “improvement”, “amelioration” or “gain” and the
terms “short-term”, “immediate”, “acute”, “rapid”, “instant” or “quick” in addition to terms
for smoking cessation. Where existing reviews were found these were used. Otherwise, primary
research findings were analysed and summarised.
3. Results
Physical health
Table 1 shows the expected physical health benefits from stopping smoking. The most notable
benefits are improved lung functioning (including a decrease in COPD symptoms), lower
heart rate, decrease in risk to the babies of smokers and faster wound healing.
Quick wins: the short-term benefits of stopping smoking
Briefing: 12
Table 1: Expected physical health benefits within 12 months of smoking cessation
Quick wins: the short-term benefits of stopping smoking
Briefing: 12
Improvement in pulmonary CO
diffusing capacity2,3 and
pulmonary epithelial
Improvement in FEV1,
decreased sputum neutrophils
in asthmatics12
Decrease in COPD/respiratory
disease symptoms (wheeziness,
expectoration, cough) and
reduced severity17–19
Improved airway hyper-activity
and respiratory symptoms in
Improved FEV1 and reduced
airway inflammation in healthy
smokers or smokers with mild
COPD;28–30 improved airway
hyper-reactivity and decreased
epithelial remodelling in COPD
patients30, 31
Improvement in
coronary vaso-
constriction, lipid
and fibrinolytic
profile and
oxidative injury5–7
Lowered arterial
pressure and
heart rate13, 14
Improved airway
and respiratory
symptoms in
Decreased risk of
primary as well
as secondary
CHD11, 32, 33
including MI;34, 35
improved survival
following surgery
for PAD11
Improvement in
rigidity and
tumescence in
men with erectile
dysfunction8, 9
improvement in
sperm quality20
Excess risk of low
birth weight and
Perinatal death
and preterm
delivery likely to
be reduced11
Reduction in daily
reflux,10 faster
gastric ulcer
Faster healing of
duodenal ulcers,26
reduced recurrence
of gastric ulcer27
Reduction in
duodenal ulcer
relapse and
Crohn’s disease
flare-up36, 37
Reduced post-
complications and
improved wound
healing15, 16
<1 months
<2 months
<3 months
<4 months
<6 months
<9 months
<12 months
Re-productive Gastro-intestinal
Table 1: Rapid health gains from stopping smoking; *Generally, most pronounced benefits are seen in those with pre-existing
conditions; CO: carbon monoxide, COPD: Chronic obstructive pulmonary disease, FEV1: Forced-expiratory volume in one second;
CHD: Coronary heart disease, PAD: Peripheral arterial disease
Below, a number of other positive effects of smoking cessation that occur within a relatively
short amount of time are presented. These include healthier appearance of the skin and
improvement of bad breath; also increased self-confidence, more social interaction and greater
engagement in other healthy behaviours.
Aesthetic improvements
Smoking is associated with a number of oral conditions such as bad breath, stained
teeth and periodontal disease and these tend to be quickly reversible in the early stages
after smoking cessation39, 40
Smoking also has dermatological consequences, and there are a number of rapid
improvements following smoking cessation, such as a reduction in the recurrence of
psoriasis, palmoplantar pustolosis and skin ulcers41
Smoking cessation also improves the appearance of skin and nails in the absence of nicotine
staining and a halting in the aging of skin and formation of wrinkles which is enhanced
in smokers42
Psychosocial improvements
There is evidence that smoking cessation is not only a consequence of higher self-confidence
(or self-efficacy) but that smoking cessation itself causes improvements in both these
cognitions within a short timeframe11, 43–45
Studies increasingly suggest that as former smokers play an active role in structuring social
interactions and support, so as to maintain abstinence and remain at the centre of social
networks, continuing smokers become pushed to the periphery and socially isolated11, 46
Improvements in other health behaviours
Smoking cessation appears to go hand in hand with fairly rapid improvements and orientation
towards other healthy life choices including increases in exercise, healthy dieting, reduction
in alcohol consumption and taking part in health screening programs11, 47–51
Quick wins: the short-term benefits of stopping smoking
Briefing: 12
Mental health
There is increasing evidence that stopping smoking yields improvement in psychological
well-being and that this occurs relatively soon after the quit date. Whilst low mood, anxiety and
feeling generally unwell are common withdrawal symptoms, they are relatively short-lived.52
In fact, within a year of stopping smoking, ex-smokers’ life enjoyment and satisfaction levels
start to increase towards the levels of a never smoker.53 Moreover, the majority of recent
ex-smokers report feeling happier than when they were a smoker.54
In terms of mental illness, there is also good evidence that the benefits from smoking cessation
are experienced relatively rapidly. Anxiety levels can start to decrease from one week after
quitting55 and this is maintained at six months, leading to a reduction in the prevalence of anxiety
disorders among ex-smokers.56
The prevalence of anxiety and depression decreases within 12 months of stopping smoking in
the general population and is not associated with any an worsening of symptoms following
smoking cessation among those with a history of mental health problems.57–59
Financial gains
Stopping smoking results in obvious financial gains. Recent data from the UK show that on
average smokers spent £5.45 for 20 hand-rolled cigarettes and £6.06 for 20 manufactured
cigarettes.60 Given that the latest figures show that smokers on average consume 12.4 cigarettes
a day,61 this means a weekly spend on cigarettes of £23.7 for hand-rolled and £26.3 for
manufactured cigarette smokers, or £1,232.40 and £1,367.60 per year; equivalent to 5.2%
of the average UK household spend.62
There are many immediate benefits or “quick gains” from stopping smoking: ranging from
improvements in physical and mental health, general well-being and appearance, plus substantial
financial savings.
Making those struggling to quit aware of these acute and rapid positive effects of smoking
cessation, and asking them to self-monitor to observe these improvements for themselves,
may strengthen their motivation to remain abstinent and provide further reasons to stick with
a quit attempt.
Quick wins: the short-term benefits of stopping smoking
Briefing: 12
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Quick wins: the short-term benefits of stopping smoking
Briefing: 12
The National Centre for Smoking Cessation and Training (NCSCT) was established to support the delivery
of smoking cessation interventions provided by local stop smoking services, support the NHS and Local
Authorities to deliver effective evidence-based tobacco control programmes, and deliver training and
assessment programmes to stop smoking practitioners and other health care professionals.
Contact details:
Telephone enquiries: 020 3137 9071
1– 6 Yarmouth Place,
Quick wins: the short-term benefits of stopping smoking
Briefing: 12
The US Food and Drug Administration has established a policy of substantially discounting the health benefits of reduced smoking in its evaluation of proposed regulations because of the cost to smokers of the supposed lost pleasure they suffer by no longer smoking. This study used data from nine countries of the former Soviet Union (fSU) to explore this association in a setting characterised by high rates of (male) smoking and smoking-related mortality. Data came from a cross-sectional population-based study undertaken in 2010/2011 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Information was collected from 18 000 respondents aged ≥18 on smoking status (never, ex-smoking and current smoking), cessation attempts and nicotine dependence. The association between these variables and self-reported happiness was examined using ordered probit regression analysis. In a pooled country analysis, never smokers and ex-smokers were both significantly happier than current smokers. Smokers with higher levels of nicotine dependence were significantly less happy than those with a low level of dependence. This study contradicts the idea that smoking is associated with greater happiness. Moreover, of relevance for policy in the fSU countries, given the lack of public knowledge about the detrimental effects of smoking on health but widespread desire to quit reported in recent research, the finding that smoking is associated with lower levels of happiness should be incorporated in future public health efforts to help encourage smokers to quit by highlighting that smoking cessation may result in better physical and emotional health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
Full-text available
Background: Smoking cessation improves physical health but it has been suggested that in vulnerable individuals it may worsen mental health. This study aimed to identify the short- and longer-term effects of stopping smoking on depression and anxiety in the general population and in those with a history of these disorders. Method: Sociodemographic and smoking characteristics, and mental and physical health were assessed using established measures in the ATTEMPT cohort, an international longitudinal study of smokers (n = 3645). Smokers who had stopped for at least 3 months or less than 3 months at the 12-month follow-up were compared with current smokers (n = 1640). Results: At follow-up, 9.7% [95% confidence interval (CI) 8.3-11.2] of smokers had stopped for less than 3 months and 7.5% (95% CI 6.3-8.9) for at least 3 months. Compared with current smokers, prevalence of depression prescriptions obtained in the last 2 weeks was lower for those who had stopped for less than 3 months [odds ratio (OR) 0.37, 95% CI 0.14-0.96] or at least 3 months (OR 0.25, 95% CI 0.06-0.94) after adjusting for baseline prescription levels and confounding variables. Adjusted prevalence of recent depression symptoms was also lower for ex-smokers who had stopped for less than 3 months (OR 0.34, 95% CI 0.15-0.78) or at least 3 months (OR 0.24, 95% CI 0.09-0.67) than among continuing smokers. There was no change in anxiety measures in the general population or any increase in anxiety or depression symptoms in ex-smokers with a past history of these conditions. Conclusions: Smoking cessation does not appear to be associated with an increase in anxiety or depression and may lead to a reduced incidence of depression.
Full-text available
Despite a lack of empirical evidence, many smokers and health professionals believe that tobacco smoking reduces anxiety, which may deter smoking cessation. The study aim was to assess whether successful smoking cessation or relapse to smoking after a quit attempt are associated with changes in anxiety. A total of 491 smokers attending National Health Service smoking cessation clinics in England were followed up 6 months after enrolment in a trial of pharmacogenetic tailoring of nicotine replacement therapy (ISRCTN14352545). There was a points difference of 11.8 (95% CI 7.7-16.0) in anxiety score 6 months after cessation between people who relapsed to smoking and people who attained abstinence. This reflected a three-point increase in anxiety from baseline for participants who relapsed and a nine-point decrease for participants who abstained. The increase in anxiety in those who relapsed was largest for those with a current diagnosis of psychiatric disorder and whose main reason for smoking was to cope with stress. The decrease in anxiety on abstinence was larger for these groups also. People who achieve abstinence experience a marked reduction in anxiety whereas those who fail to quit experience a modest increase in the long term. These data contradict the assumption that smoking is a stress reliever, but suggest that failure of a quit attempt may generate anxiety.
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The literature was reviewed to determine the risks or benefits of short-term (less than four weeks) smoking cessation on postoperative complications and to derive the minimum duration of preoperative abstinence from smoking required to reduce such complications in adult surgical patients. We searched MEDLINE, EMBASE, Cochrane, and other relevant databases for cohort studies and randomized controlled trials that reported postoperative complications (i.e., respiratory, cardiovascular, wound-healing) and mortality in patients who quit smoking within six months of surgery. Using a random effects model, meta-analyses were conducted to compare the relative risks of complications in ex-smokers with varying intervals of smoking cessation vs the risks in current smokers. We included 25 studies. Compared with current smokers, the risk of respiratory complications was similar in smokers who quit less than two or two to four weeks before surgery (risk ratio [RR] 1.20; 95% confidence interval [CI] 0.96 to 1.50 vs RR 1.14; CI 0.90 to 1.45, respectively). Smokers who quit more than four and more than eight weeks before surgery had lower risks of respiratory complications than current smokers (RR 0.77; 95% CI 0.61 to 0.96 and RR 0.53; 95% CI 0.37 to 0.76, respectively). For wound-healing complications, the risk was less in smokers who quit more than three to four weeks before surgery than in current smokers (RR 0.69; 95% CI 0.56 to 0.84). Few studies reported cardiovascular complications and there were few deaths. At least four weeks of abstinence from smoking reduces respiratory complications, and abstinence of at least three to four weeks reduces wound-healing complications. Short-term (less than four weeks) smoking cessation does not appear to increase or reduce the risk of postoperative respiratory complications.
Full-text available
Social learning theory considers self-efficacy as a causal factor in behavior change. However, in line with behavioral theory, recent clinical research suggests self-efficacy ratings may reflect, rather than cause, behavior change. To test these two disparate views, self-efficacy was related to actual smoking abstinence on the next day (i.e., self-efficacy causes change), and abstinence status over 1 day was tested as a predictor of rated self-efficacy for quitting the next day (i.e., reflects change). All data were from two similar crossover studies evaluating the short-term effects of both placebo versus medication, nicotine patch (n = 209) or varenicline (n = 123), on smoking abstinence during week-long practice quit attempts. Placebo and active medication periods were separated by an ad lib smoking washout, and analyses were controlled for prior-day's abstinence or self-efficacy values. Results were very consistent between studies in showing essentially bidirectional associations: daily self-efficacy predicted next-day's abstinence, and current-day's abstinence status predicted self-efficacy for abstinence the next day. However, secondary factors differentially predicted abstinence and, to a lesser extent, self-efficacy, between these two medication studies. These data provide some support for both social learning and behavioral theories of smoking behavior change, although self-efficacy may only briefly predict subsequent short periods of abstinence as assessed in these studies. Nonetheless, because self-efficacy has long been assumed to cause behavior change, including smoking cessation, the notion of self-efficacy as a reflection of recent smoking behavior change in these studies warrants greater attention in clinical research on smoking cessation treatment.
Research studies indicate that smoking cigarettes is related to a premature development of facial wrinkles. Given that facial wrinkles may act as motivation for people to quit smoking, it is crucial that smoking cessation professionals be able to accurately inform clients about research concerning smoking and wrinkles. Therefore, the purpose of this article is to provide an updated overview of the literature which can be used by cessation clinicians as a practical reference on smoking and facial wrinkles. Databases were searched for peer-reviewed articles that study the association with smoking and wrinkles. In all, 17 articles were located and reviewed for research methods and results. Although facial wrinkles and smoking were measured inconsistently between studies, the overall literature indicates that those who smoke have a higher risk of developing premature facial wrinkles as compared to those who do not smoke. The implications of this review for smoking cessation professionals are described.
Previous research has indicated a strong association of smoking with depression and anxiety disorders, but the direction of the relationship is uncertain. Most research has been done in general population samples. We investigated the effect of smoking and nicotine dependence on the severity and course of depressive and anxiety symptoms in psychiatric patients. Data came from the Netherlands Study of Depression and Anxiety (NESDA) including participants with a current diagnosis of depression and/or an anxiety disorder (N=1725). The course of smoking status and symptoms of depression, general anxiety, social anxiety, and agoraphobia were measured at baseline and after one and two years. Age, gender, education, alcohol use, physical activity, and negative life events were treated as covariates. At baseline, the symptoms of depression, general anxiety, and agoraphobia were more severe in nicotine-dependent smokers than in never-smokers, former smokers, and non-dependent smokers. These differences remained after adjusting for covariates. Smaller differences were observed for severity of social anxiety which were no longer significant after controlling for covariates. Over a two-year follow-up, the improvement of depressive and anxiety symptoms was slower in nicotine-dependent smokers than in the other groups even after controlling for covariates. There were no differences between the groups in the course of symptoms of social anxiety and agoraphobia over time. In psychiatric patients, smoking is associated with higher severity of depressive and anxiety symptoms, and with slower recovery, but only when smokers are nicotine-dependent.
Isoprostanes (IP) have been identified as reliable markers of in vivo oxidation injury. Recently, in vascular tissue and blood as well as urine of cigarette smokers, increased IP values have been discovered. We examined 47 adults (26 males, 21 females; aged 30–66 years), admitted to a cardiovascular unit on an outpatient basis, with various risk factors but without any sign of manifestation of atherosclerosis. Refraining from cigarette smoking for a few days resulted in a significant drop of plasma, serum, and urinary 8-epi-PGF2α. Thereafter, a further continuous decrease was monitored, reaching a steady state after about 4 weeks after quitting cigarette smoking. Prevalues of 8-epi-PGF2α were higher, depending on the type and number of risk factors; the decrease after quitting, however, was comparable. These results indicate that exsmokers may rapidly recover from their enhanced in vivo oxidation.
Cigarette smoking has been associated with significant morbidity affecting all systems of the body, including the integumentary system. We review the many dermatologic hazards of tobacco use. It is important to distinguish between the effects of tobacco smoke from effects of pure nicotine on the skin. All skin cells express several subtypes of the nicotinic class of acetylcholine receptors, including the α7 receptor. Many chronic dermatoses are affected by smoking either negatively or positively. Elucidation of positive associations with a particular disease can lead to improvement from smoking cessation, whereas inverse correlation may lead to development of a disease-specific treatment with nicotinergic agonists.
Happiness has become established as an important psychological dimension and not merely the obverse of depression and anxiety. Ex-smokers report that they are happier than when they were smoking but this could reflect biased recall. To date, no studies have examined happiness as a function of smoking status in ex-smokers of varying length of abstinence compared with current and never smokers. A cross-sectional household study of a nationally representative sample of adults examined the association between smoking status (never smoker, smoker, ex-smoker<1 year, ex-smoker ≥ 1 year) and two standard measures of happiness adjusting for sociodemographic characteristics (N=6923). After adjusting for age, gender and social grade, ex-smokers of ≥ 1 year reported higher levels of happiness than smokers (p<0.001) and similar levels to never smokers. Ex-smokers of <1 year had similar levels to smokers. Smoking to feel less depressed (p<0.001) or anxious (p<0.044) were the only smoking characteristics associated with lower happiness among current smokers. Ex-smokers who have stopped for a year or more are happier than current smokers and similar to never smokers. Whilst these results are cross-sectional and have to be interpreted with caution, this adds to the evidence that smoking may decrease happiness and stopping may increase it.