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Cohort study
Two-thirds of female smokers aged over 50 die from smoking-related causes, but quitting before 40 decreases this by 90%
  1. Mary E Cooley1,
  2. Elyse R Park2
  1. 1Phyllis F. Cantor Center, Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
  2. 2Massachusetts General Hospital Tobacco Research & Treatment Center, Boston, Massachusetts, USA
  1. Correspondence to: Dr Mary E Cooley
    Research in Nursing and Patient Care, Dana Farber Cancer Institute, 450 Brookline Ave, LW-512, Boston, MA 02025, USA; mary_cooley{at}

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Commentary on: Pirie K, Peto R, Reeves GK, et al. Million Women Study Collaborators. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet 2013;381:133–41.


Smoking is the leading cause of preventable death. Given that women born after 1940 smoked throughout their lifespan, studies of mortality during the 21st century are needed to understand the hazards associated with prolonged smoking and cessation.


In this prospective cohort study, participants completed mailed questionnaires about lifestyle, medical history and demographic factors; surveys were repeated 3 and 8 years later.1 Dates and causes of death were assessed through national records. At entry, women were asked if they were a current or ex-smoker and how many cigarettes they smoked. At 3-year follow-up, women were asked at …

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