How long does the average smoker live?

There is no single age that an average smoker can be expected to reach. Studies compare large groups of people: in the US study by Jha and colleagues published in 2013, life expectancy among current smokers was more than 10 years shorter than among people classified as nonsmokers in the study (Jha et al., NEJM 2013). This is an average for the study population, not a prediction for an individual. The same data show that quitting smoking was associated with a longer life, including among people in their forties and fifties.

In short

• In studies from the US and the UK, current smokers lived about 10 years less on average than people who had never smoked.
• This average includes both people who died because of smoking and lost more than 20 years of life, and people whose lives were not shortened by smoking. Some smokers reach 90, but in the study of British doctors, the probability of surviving from age 70 to 90 was lower among smokers than among nonsmokers.
• Most excess deaths among smokers are caused by cancers, heart and blood vessel diseases, and respiratory diseases, not just lung cancer.
• Quitting smoking was associated with a longer life in every age group studied. The greatest benefit was observed among people who stopped before age 40.

How many years does smoking take off life expectancy?

People who smoke cigarettes live about 10 years less on average than people who have never smoked. This difference has been described in both women and men in large cohort studies, which follow thousands of people over many years.

Prabhat Jha's team analysed data from more than 200,000 adults aged 25 and over who took part in the US National Health Interview Survey between 1997 and 2004. Answers to questions about smoking were linked to death registry data through the end of 2006. The researchers compared current smokers with a group classified as nonsmokers: life expectancy in the first group was more than 10 years shorter (Jha et al., NEJM 2013).

In the study by Jha and colleagues, the comparison group included people who had smoked fewer than 100 cigarettes in their entire lives, including those who had only tried smoking. The reported difference in life expectancy does not describe the effect of smoking a single cigarette. The 100-cigarette threshold was used to classify participants; it did not define a safe dose.

In the same study, the probability that a woman aged 25 would reach age 79 was 38% among smokers and 70% among women in the nonsmoking group. For men, the corresponding figures were 26% and 61%. The calculations accounted for age, education, obesity and alcohol consumption.

A similar result was found in the UK. In the Million Women Study, which included 1.2 million women, the authors combined their findings with national mortality data and estimated an 11-year difference in life expectancy between smokers and nonsmokers (Pirie et al., Lancet 2013). In the 50-year follow-up of British doctors, men born between 1900 and 1930 who smoked cigarettes and did not quit died about 10 years earlier on average than lifelong nonsmokers (Doll et al., BMJ 2004).

Why do some smokers live to 90?

Some people who smoke reach old age because smoking does not shorten everyone's life by the same number of years. Some lose decades, while others lose no years at all.

The analysis by Cho and colleagues published in 2024 illustrates this. Between ages 40 and 79, women who smoked lived an average of 12 years less, and men who smoked 13 years less, than people who had never smoked. According to the authors, this average reflects two groups: smokers who died because of smoking and lost around 24-26 years, and smokers whose deaths were not caused by smoking (Cho et al., NEJM Evidence 2024).

In the study of British doctors, the probability of surviving from age 70 to 90 was lower among cigarette smokers than among nonsmokers. Based on mortality rates in the 1990s, it was estimated at 7% and 33%, respectively (Doll et al., BMJ 2004).

Smoking history also matters. In the same study, cigarette smoking increased mortality less among men born in the 19th century than among those born in the 1920s. The authors explain that the younger generation started smoking earlier and smoked more. This is why the story of one person from another generation tells us little about the risk faced by someone who smokes today.

The Jha and Cho studies accounted for education, alcohol consumption and obesity, because these factors also affect mortality risk. An individual case cannot establish why that particular person lived to 90.

How does smoking lead to premature death?

Most excess deaths among people who smoke are caused by cancers, cardiovascular diseases and respiratory diseases that smoking can cause (Jha et al., NEJM 2013). Lung cancer is only one of these conditions.

Tobacco smoke contains more than 7,000 chemicals. At least 250 have been identified as harmful, and at least 69 as carcinogenic. Smoking causes cancers of the lung, larynx, mouth, oesophagus, stomach, pancreas, kidney, bladder and colon, among others. It also causes heart disease, stroke, aortic aneurysm and chronic obstructive pulmonary disease, or COPD (National Cancer Institute).

In the British study of one million women, smoking was associated with a significantly higher risk of death from 23 of the 30 most common causes of death (Pirie et al., Lancet 2013). In an analysis of five US cohorts of people aged at least 55, around 17% of excess deaths among smokers were associated with diseases that, when the study was published in 2015, were not formally recognised as caused by smoking. These included kidney failure, intestinal ischaemia and infections (Carter et al., NEJM 2015).

Can quitting smoking extend your life?

Yes. In cohort studies, people who quit smoking lived longer than those who continued, and this applied to every age group analysed. The greatest benefit was observed among people who stopped before age 40 (Cho et al., NEJM Evidence 2024).

How many years of life do people gain by quitting?

In the study by Jha and colleagues, people who quit at ages 25-34, 35-44 and 45-54 gained around 10, 9 and 6 years of life, respectively, compared with people who continued smoking. Similar figures were reported in the follow-up of British doctors (Doll et al., BMJ 2004).

Is it too late after many years of smoking?

The analysis by Cho and colleagues included 1.48 million adults aged 20-79 from four study groups in the US, the UK, Norway and Canada. Participants were followed for 15 years. Compared with people who had never smoked, the mortality hazard ratio was 2.8 in women who smoked and 2.7 in men who smoked, and 1.3 in former smokers. A value of 1.0 would mean the same mortality hazard as in people who had never smoked.

The authors also calculated excess risk, meaning the part of mortality risk above that of people who had never smoked. Among people who had quit less than 3 years earlier, excess risk was lower than among those who continued smoking. Before age 40, the difference was 95% for women and 90% for men. At ages 40-49, it was 81% and 61%, respectively, and at ages 50-59, 63% and 54%. These percentages concern excess risk alone. Total mortality risk does not fall by the same percentage.

The authors estimated that quitting less than 3 years earlier could potentially avert the loss of around 5 years of life compared with continuing to smoke. After at least 10 years since quitting, the estimated difference was around 10 years. Life expectancy in this second group was close to that of people who had never smoked (Cho et al., NEJM Evidence 2024).

These are findings from observational studies. They show an association between quitting smoking and longer survival in large groups, but cannot predict how many years a particular person will gain.

Where should you start if you want to quit smoking?

Treatment begins with a conversation with a specialist about your smoking history, previous attempts to quit, chronic conditions and medicines you take. This information helps determine which treatment is appropriate.

In its 2024 guideline, the World Health Organization recommends offering adults who want to quit smoking medication together with behavioural support, meaning individual, group or telephone counselling with a specialist (WHO 2024). A specialist selects the medication after assessing your health. This article does not replace a consultation.

If you want to quit smoking and need support, find out about nicotine dependence treatment at Nasz Gabinet.

Frequently asked questions

Does every cigarette shorten life by the same amount?

No. Risk does not increase in direct proportion to the number of cigarettes, and even a small number is associated with a clearly higher mortality risk. In the US NIH-AARP study, participants were aged 59-82 at the start of follow-up. Among people reporting consistent smoking of less than 1 cigarette a day during the periods of life in which they smoked, the mortality hazard ratio (HR) was 1.64. For 1-10 cigarettes a day, it was 1.87 compared with people who had never smoked (Inoue-Choi et al., JAMA Internal Medicine 2017). HR compares the rate at which deaths occur during follow-up; it does not give the probability that a particular person will die. In the Million Women Study, mortality over 12 years was also nearly twice as high in women smoking fewer than 10 cigarettes a day as in women who had never smoked (Pirie et al., Lancet 2013).

Can I calculate how many years of life smoking has cost me?

This cannot be calculated reliably for one person. Data on years of life lost describe averages for large groups: some smokers lose more than 20 years, while others do not have their lives shortened by smoking (Cho et al., NEJM Evidence 2024). However, the studies show that quitting at every age analysed was associated with a longer life than continuing to smoke.

Do these findings also apply to e-cigarettes?

No. The studies described concerned cigarette smoking, so their results cannot be applied directly to e-cigarettes, nicotine pouches or nicotine replacement therapy. The risks of each product must be assessed using separate studies. Switching from cigarettes to e-cigarettes also does not mean stopping nicotine use.

Sources

• Jha P, Ramasundarahettige C, Landsman V et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341-350. PMID 23343063, DOI
• Cho ER, Brill IK, Gram IT et al. Smoking Cessation and Short- and Longer-Term Mortality. NEJM Evid. 2024;3(3):EVIDoa2300272. PMID 38329816, DOI
• Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328(7455):1519. PMID 15213107, DOI
• Pirie K, Peto R, Reeves GK et al. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013;381(9861):133-141. PMID 23107252, DOI
• Carter BD, Abnet CC, Feskanich D et al. Smoking and mortality - beyond established causes. N Engl J Med. 2015;372(7):631-640. PMID 25671255, DOI
• Inoue-Choi M, Liao LM, Reyes-Guzman C et al. Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the NIH-AARP Diet and Health Study. JAMA Intern Med. 2017;177(1):87-95. PMID 27918784, DOI
• National Cancer Institute. Harms of Cigarette Smoking and Health Benefits of Quitting. cancer.gov
• World Health Organization. WHO clinical treatment guideline for tobacco cessation in adults. 2024. who.int