{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:30:40Z","timestamp":1793305840800,"version":"4.5.0"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi241223-4\"><jats:title>Importance<\/jats:title><jats:p>The association between smoking cessation and cardiovascular disease (CVD) risk in relation to cumulative smoking exposure remains poorly understood.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the associations among smoking cessation, lifetime smoking burden, and CVD risk according to the number of years elapsed after smoking cessation.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study of the Korean National Health Insurance Service database investigated smoking duration and intensity between January 2006 and December 2008. Participants were categorized by self-reported smoking habits as current, ex-, or never-smokers. Smoking records were updated every 2 years until December 2019, with participants whose smoking status changed or whose smoking status was unclear excluded. Data analysis was performed between June and December 2022.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-7\"><jats:title>Exposures<\/jats:title><jats:p>Time-updated self-reported smoking status, years since quitting, and cumulative smoking amount (pack-years [PY]).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary outcome was incidence and hazard ratio of CVD (composite of cardiovascular death, myocardial infarction, stroke, and heart failure).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-9\"><jats:title>Results<\/jats:title><jats:p>Overall, 5\u202f391\u202f231 participants (39.9% male; mean [SD] age, 45.8 [14.7] years; 853\u202f756 [15.8%] current smokers, 104\u202f604 [1.9%] ex-smokers, and 4\u202f432\u202f871 [82.2%] never smokers) were followed up for a mean (SD) of 4.2 (4.4) years. The median (IQR) baseline cumulative smoking amounts were 14.0 (7.5-20.0) PY in current smokers and 10.5 (5.3-20.0) PY in ex-smokers. The median (IQR) duration of smoking cessation was 4 (2-8) years for ex-smokers. Regardless of continued smoking, a dose-dependent association was evident between smoking and incident CVD. Compared with current smokers, ex-smokers with a lifetime smoking burden of less than 8 PY (light ex-smokers) experienced a significant reduction in CVD risk within 10 years of cessation, with a CVD risk similar to that of never-smokers. Conversely, ex-smokers with at least 8 PY (heavy ex-smokers) exhibited a slower decline in CVD risk than light ex-smokers, requiring more than 25 years for the residual CVD risk to disappear.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi241223-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, smoking and CVD risk exhibited a dose-dependent association, with light ex-smokers having a CVD risk similar to that of never-smokers relatively soon after smoking cessation. For heavy ex-smokers, greater than 25 years might be required for the residual CVD risk to align with that of never-smokers.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.42639","type":"journal-article","created":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T15:31:23Z","timestamp":1730475083000},"page":"e2442639","source":"Crossref","is-referenced-by-count":53,"title":["Smoking Cessation and Incident Cardiovascular Disease"],"prefix":"10.1001","volume":"7","author":[{"given":"Jun Hwan","family":"Cho","sequence":"first","affiliation":[{"name":"Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea"},{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung Yong","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hoseob","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hanmi Pharm Co Ltd, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Data Science, Hanmi Pharm Co Ltd, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeongmin","family":"Byeon","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea"},{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moonki","family":"Jung","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea"},{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ki-Woon","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital College of Medicine, Seoul, Republic of Korea"},{"name":"Cardiovascular and Arrhythmia Center, Chung-Ang University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang-Soo","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chung-Ang University Hospital College of Medicine, Seoul, Republic of Korea"},{"name":"Cardiovascular and Arrhythmia Center, Chung-Ang University Hospital, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang-Wook","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Republic of Korea"},{"name":"Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,11,1]]},"reference":[{"key":"zoi241223r1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000950"},{"key":"zoi241223r2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)69249-0"},{"key":"zoi241223r3","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30752-2"},{"key":"zoi241223r5","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-013-9835-6"},{"key":"zoi241223r6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1211128"},{"key":"zoi241223r7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab484"},{"key":"zoi241223r8","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000678"},{"key":"zoi241223r9","doi-asserted-by":"publisher","DOI":"10.56786\/PHWR.2023.16.20.4"},{"key":"zoi241223r10","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab309"},{"key":"zoi241223r11","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab312"},{"key":"zoi241223r12","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000467"},{"key":"zoi241223r13","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2020.0171"},{"key":"zoi241223r14"},{"key":"zoi241223r15","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10112238"},{"key":"zoi241223r16","doi-asserted-by":"publisher","DOI":"10.3389\/fepid.2023.1283705"},{"key":"zoi241223r17","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011696"},{"key":"zoi241223r18","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv013"},{"key":"zoi241223r19","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.11.016"},{"key":"zoi241223r20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.10298"},{"key":"zoi241223r21","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.9649"},{"key":"zoi241223r22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(86)92017-9"},{"key":"zoi241223r23","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420020075009"},{"key":"zoi241223r24","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-013-9776-0"},{"key":"zoi241223r25","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehad616"},{"key":"zoi241223r26","doi-asserted-by":"publisher","DOI":"10.1080\/14622200210141266"},{"key":"zoi241223r4"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2825743\/cho_2024_oi_241223_1729881985.86925.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,1]],"date-time":"2024-11-01T15:31:24Z","timestamp":1730475084000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2825743"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,1]]},"references-count":26,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11,4]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.42639","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,1]]}}}