Smoking Quintuples Heart Attack Risk In 30s, 40s Because Young People Generally Healthier, Effects Show Up Sharply

A major new study shows that smokers in their 30s and 40s are five times as likely to have a heart attack as non-smokers, a finding that could add steam to President Clinton’s current anti-smoking campaign.

While the new study, published today in the British Medical Journal, is consistent with a huge body of evidence on the overall dangers of smoking, “it does change the idea that smoking only kills older people,” said Richard Peto, a study author and medical statistician at the University of Oxford.

The study, which focused on 14,000 British heart attack survivors and 32,000 of their relatives, found that smokers in their 50s have three times as many heart attacks as non-smokers, and those in their 60s and 70s twice as many.

Because younger people are generally healthier, the effect of smoking shows up most sharply in these age groups. In later life, smoking has a less dramatic effect on heart attacks because other risks contribute heavily to cardiac problems.

Peto hopes the new study will help make the danger of smoking seem more real to young people.

“People in their 20s might just be able to glimpse the fact that they might one day be in their 30s. They certainly don’t believe they will be in their 50s. So what happens in the 30s is more relevant than the 50s in terms of how people perceive things,” he said in a telephone interview.

“These results mean that in the United States, at age 30 to 49, smoking is now causing about 40,000 heart attacks a year. That’s (almost) enough to fill Fenway Park,” said Peto.

Dr. Douglas Johnson, a pulmonary specialist at Massachusetts General Hospital who co-authored a scientific position paper on smoking for the American Heart Association, agreed that the new study “provides further evidence of the damage that smoking causes, particularly for young people.

“It provides yet another reason why efforts should be made to prevent children from starting to smoke in the first place.”

Mitchell Zeller, special assistant for policy at the Food and Drug Administration in Rockville, Md., called the study “very significant,” especially in light of FDA proposals announced last week calling for more stringent regulation of cigarette sales and advertising aimed at teenagers.

“I think most people associated the lung cancer and emphysema and cardiovascular disease with smoking but think it takes place much later in life,” Zeller said.

The British researchers found that the heart attack risk was slighter higher with medium-tar cigarettes than with low-tar brands, but the difference was small.

While this study focused primarily on smoking and heart attack risk, other data compiled by Peto and his team provide a dramatic picture of the worldwide effects of smoking.

For instance:

Of the 30 million adults who die every year worldwide, 3 million die from smoking-related illnesses.

One person dies from smoking every 10 seconds, according to a new report by scientists at the Imperial Cancer Research Fund in Oxford, the World Health Organization in Geneva and the American Cancer Society in Atlanta. If current smoking trends persist, there will be one smoking-related death every 3 seconds by the time the young smokers of today reach middle or old age.

Of every 1,000 US 20-year-olds who smoke regularly, roughly six will eventually die from homicide and 12 from motor vehicle accidents. But 250 will die of smoking by middle age, and another 250 in later life.

Not only is smoking a major contributor to cardiac disease and death, it is the chief culprit behind what many lay people view as an epidemic of cancer deaths, Peto’s team finds.

“The common belief that there is an epidemic of death from cancer in developed countries is a myth, except for the effects of tobacco,” Peto said. “If we take away the cancer deaths that are attributed to smoking, then the cancer death rates that remain are, if anything, declining.”

The American Cancer Society agrees. “If lung cancer deaths were excluded, cancer mortality would have declined 14 percent between 1950 and 1990,” the group said.