The study linked surveys of 217,000 adults collected for the federal National Health Interview Survey between 1997 and 2004 to cause-of-death records in the National Death Index.
Previous long-term studies of smokers followed specific groups who were likely healthier than the general population, such as nurses or physicians, said Jha, marking the new study as more representative of the risks of smoking — and the benefits of dropping the habit — across the entire nation.
A second report, also published in the New England Journal of Medicine, showed that smoking-related deaths among women have soared in recent decades. For the first time since research on smoking and health began in the 1950s, the rate of smoking-related deaths is now nearly equal between male and female smokers.
Women took to cigarettes in large numbers only after World War II, lagging behind men by about 20 years. The consequences of that shift are just now reaching women in their mid-50s and older. Meanwhile, lung cancer risk in male smokers leveled off in the 1980s.
"As the Mad Men generation has matured, the risks in women who smoke continue to increase," said Michael Thun of the American Cancer Society, lead author of the second report, which drew on that group's Cancer Prevention Study. That study tracked 1.2 million men and women through 2010.
"We used to think women were at less risk of illness from smoking," said Steven Schroeder, a smoking and health expert at the University of California, San Francisco, who was not involved in either study. "That doesn't seem to be true now. My guess is that early women smokers didn't smoke as much as men because there was some stigma to it. Now they're smoking as many cigarettes as men are."
In other words, he said: "Smoke like a man, die like a man."