Background The aim of this study was to examine the changes in smoking behavior over 6 years and to relate these changes to mortality risk during 18 years’ follow-up. Methods We followed a cohort for 6 years (1991–1997) to assess changes in smoking behavior and then for an additional 12 years (1997–2008) to relate these findings to mortality in 4986 Chinese individuals. Participants were classified as never smokers, long-term quitters, new smokers, new quitters, and continuing smokers. Mortality was ascertained by linkage with the nationwide death registry. Results Compared with never smokers, continuing smokers had the highest risk of 1.84 [95% confidence interval (CI): 1.38, 2.45] for all-cause mortality, new quitters had a risk of 1.49 (95% CI: 1.04, 2.15), new smokers had a risk of 1.26 (95% CI: 0.59, 2.68), and long-term quitters had a risk of 1.11 (95% CI: 0.64, 1.91). There was a significant 19% risk reduction in all-cause mortality for new quitters. Conclusion Smoking cessation was associated with a significant reduction in mortality risk within approximately 6 years, while no significantly increased risk was observed for long-term quitters.
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