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Yes, quitting
smoking entirely is best. For those unwilling to quit entirely,
switching to snuff gives almost the same benefit, especially under age
60.
Smokers who switched from
smoking to smokeless, adjusting for age, the number of pack years of cigarettes
previously smoked, and many other factors, incurred an 8% higher all
cause mortality risk than smokers who quit entirely, according to the
American Cancer Society Prevention study II.1 However, in
their smoking years, switchers may have smoked their cigarettes more
intensively per cigarette than the smokers who quit entirely, inflating
the apparent increased risks from switching.1 The extra risk
for switchers over and above quitting entirely, is one death per 100
smokers quitting at age 50-54.2
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At age 65-69, this extra risk rises to five per 100
quitters. 2
In ACSII, switchers actually
switched and stopped smoking 2-3 years later than those entirely
quitting. The excess risk of switching over entire quitting would be
less than in ACSII, if smokers, finding it easier to switch than to
quit entirely, switched sooner, after fewer pack years of smoking.
Caution. This
was not a controlled experiment, but a follow-up of smokers. Statistical
adjustments were made to control for big differences between the two
groups in education and occupation. The switchers were much less well
educated, than those quitting entirely.
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