Heart risk drops in women ex-smokers.

Heart risk drops in women ex-smokers

The risk of a first heart attack declines rapidly in women smokers who kick the habit, approaching within a few years the risk seen among nonsmokers, new research indicates. This risk reduction, previously observed in men but never before documented in women, should provide new incentive for women to quit smoking, say the researchers and others.

Moreover, the study may fuel the fire of public opinion against tobacco companies that target their advertising at specific audiences such as women -- a technique used increasingly by those companies as they attempt to recruit new smokers to replace the growing ranks of those who have quit. Last week, R.J. Reynolds Tobacco Co. canceled its plans to test market a new cigarette aimed at blacks, after consumer groups and others -- including Health and Human Services Secretary Louis W. Sullivan -- lambasted the company for its planned campaign.

The prevalence of smoking has steadily declined in the United States in the past two decades, but the trend among females is less robust than among males. Between 1964 and 1986, for example, the proportion of cigarette-smoking men declined by almost one-half, to a level of 29 percent of the U.S. male population; the proportion of women smokers dropped by only one-third, to a level of about 24 percent. The difference stems in part from women's lower success rate in quitting smoking, as documented in several studies. Rather than stop smoking, many women switch to "low-yield" brands, despite evidence that these cigarettes carry about the same risk of heart attack as higher-yield brands.

"Women don't seem to realize that if they smoke they greatly increase the risk of heart attack," says Lynn Rosenberg, who performed the latest study with Julie R. Palmer and Samuel Shapiro of the Boston University School of Medicine. "Now they should also recognize that if they give it up, that risk will virtually disappear within three to four years."

With that knowledge, women might be more inclined to quit than to switch brands, the researchers conclude in the Jan. 25 NEW ENGLAND JOURNAL OF MEDICINE. Their data, drawn from more than 3,000 women, show that the risk of heart attack three years after a woman quits -- no matter how long she smoked or how many cigarettes she smoked per day -- is "virtually indistinguishable" from that of a woman who never smoked.

The finding is "very important" and supports the view that smoking-related heart attacks result from more than a simple accumulation of fatty plaques inside coronary blood vessels, says Bernard Gersh, a cardiologist at the Mayo Clinic in Rochester, Minn. He speculates that cigarette smoke may disrupt these plaques and attract circulating platelets, which can collect at the site and trigger a heart attack. Others suggest smoking can initiate fatal spasms in arteries supplying blood to the heart.

The Women vs. Smoking Network, a consumer group based on Washington, D.C., hails the Boston group's finding as one more reason for women to resist the barrage of cigarette advertising focusing exclusively on women. By the mid-1990s, the proportion of women smokers will exceed that of men, predicts physician Michele Bloch, who directs the Network. "That's a change of historic significance," she says, but the trend might be averted if women recognize that quitting can reverse their high-risk status.