“Too late – the damage is already done.” This mantra keeps many smokers trapped. The data argue otherwise. Those who quit at 35, 45, 55, 65, or even 75 years old gain years of life expectancy back on average – even at an advanced age, the curve can still be significantly turned ^[1]. And patients who manage to quit smoking at the time of a cancer diagnosis live longer overall and experience fewer relapses – an effect that is observable across various types of cancer ^[2]. The myth “It’s too late to make a difference” therefore belongs in the past.

Smoking is more than just nicotine. Smoke contains a mixture of thousands of substances, including fine particulate matter, oxidants, and carcinogenic compounds. These substances trigger chronic inflammationpersistent inflammatory activity in the body, promote atherosclerosisvascular calcification due to plaque formation in arteries, and damage epitheliumprotective cell layer on organ surfaces in the lungs and blood vessels. Passive smoking includes secondhand smokeinhaled smoke from others and thirdhand smokeresidual smoke particles on surfaces that are subsequently released – both carry similar toxins as mainstream smoke. For high performers, it is important to note: These processes deplete energy, recovery, and resilience. Those who manage to quit not only stop the intake of toxins but also give the body a chance to activate repair programs.

Cardiovascularly, every cigarette counts. Studies show a clear dose-response relationship between smoking intensity, accumulated “pack-years,” and markers for inflammation, blood coagulation, and subclinical atherosclerosis. The more and the longer one smokes, the worse these markers present. After quitting smoking, they decrease over time – many normalize nearly after decades, although coronary calcification values may remain elevated longer ^[3]. This is reflected in events: Smoking significantly increases the risk of heart attack and stroke; nevertheless, many underestimate the danger, especially men and long-term smokers [Ref39833765; Ref39180018]. The airways also benefit, although not always measurable immediately: In clinical data, FEV1 tends to improve slightly, while the major clinical benefits – fewer exacerbations, slower progression, lower mortality – clearly prevail in the long term ^[4]. Quitting smoking sharpens the senses: taste thresholds decrease, and the density and blood flow of taste buds partially recover – an underestimated gain for quality of life and enjoyment competence ^[5]. Psychologically, quitting provides relief, especially for cancer patients: Reduced internalized stigma correlates with less anxiety – a tangible lever for well-being in an already challenging situation ^[6]. For pregnant women, abstinence is crucial: nicotine passes through the placenta and influences early neuronal networks. Smoking as well as nicotine products increase the risks for preterm birth, low birth weight, sudden infant death syndrome (SIDS), and neurodevelopmental abnormalities – a strong argument for quitting early and completely [Ref37466776; Ref36755185; Ref38389806]. Moreover, non-smokers benefit: Passive smoke promotes oxidative damage, inflammation, and DNA changes even in the smallest airways – the risk for lung cancer and cardiopulmonary diseases measurably increases [Ref40738372; Ref40950280].

Large cohort data establish the long-term perspective: In an analysis involving 22 cohorts, inflammatory and atherosclerosis markers were clearly elevated in smokers in a dose-response relationship; values significantly decreased with increasing time after quitting. After about 30 years of adjustment, most markers no longer differed from those of lifelong non-smokers – with the exception of the coronary calcium score, which remained moderately elevated. This illustrates that the circulation benefits early, while structural vascular remodeling takes significantly longer ^[3]. A recent lifespan analysis quantified the gain from quitting specifically: Those who stop in middle age prevent most of the otherwise lost years of life; even at 65 or 75 years of age, there remains a real chance to gain at least one additional year of life ^[1]. And in the clinical extreme case of cancer? A systematic review and meta-analysis showed that patients who quit smoking at the time of diagnosis live longer and experience less progression and fewer relapses – regardless of tumor location and also robust after methodological adjustments. This justifies smoking cessation programs as an integral component of oncological treatment pathways ^[2].

- Set a quit date within the next 14 days and plan for fallback nets: Nicotine replacement (patch plus on-demand spray) or varenicline/bupropion after medical consultation increase the chance of success. Quitting early saves the most years of life; even a late stop brings measurable benefits ^[1].
- If you have or had cancer: Actively ask your treatment team for a structured cessation program. Quitting smoking at the time of diagnosis improves survival and disease control – this is part of therapy, not a “nice to have” ^[2].
- Retrain your breathing: Supplement the cessation with daily lung hygiene – e.g., 5-10 minutes of breathing exercises with extended exhalation and moderate endurance training. Short-term FEV1 gains are small, but in the long term, exacerbations decrease and progression slows down ^[4].
- Reclaim enjoyment: Use the recovery of taste and smell as motivation. Cook with rich flavors, experiment with new fruits/vegetables, and consciously pay attention to textures – the taste buds structurally recover, and thresholds decrease measurably ^[5].
- Strengthen your psyche: Link quitting smoking to stress tools (2-minute cold water on forearms, 10-minute walk, 60-second box breathing). Reduced internalized stigma after quitting correlates with less anxiety – especially during stressful disease phases, this is a valuable lever ^[6].
- Detox your environment: Declare your home and car as smoke-free zones. This protects roommates from secondhand and thirdhand smoke, which have been shown to promote inflammation and lung damage [Ref40738372; Ref40950280].
- Pregnancy? Zero tolerance for nicotine – also avoid snus and e-cigarettes. Early cessation significantly reduces risks for SIDS, preterm birth, and developmental issues [Ref36755185; Ref37466776; Ref38389806].

Quitting smoking is one of the strongest levers for longevity, performance, and quality of life – and it works at almost any age. Those who start today stop inflammation, protect blood vessels, sharpen senses, and gain real years of life. Ask yourself: What first small decision will you make today?