# Who dies first? Smokers or people who don't exercise?

Hey guys, I’ve got a pal who smokes, and all these years I’ve been telling him to quit. But I guess one day I finally got on his nerves and he told me “Look, Andy. I’m a smoker, but I bet I’ll live longer than you because I exercise regularly!”. Well, admittedly, I don’t exercise… not at all. I work at a desk job, I drive right up to my doorway, I eat dinner, I have a few beers, watch TV, and then I go to bed… rinse and repeat.

So my question is… if two guys were of the same life expectancy at birth, and one of them turns out to be a regular smoker (20 sticks a day), but exercises regularly (jogs daily, plays sports 3 times a week), and the other is like 90% of every other person on earth now (eats, sleeps, farts), but doesn’t smoke. who would likely die first? My head is still telling me that the smokers will die first, but my gut (pun intended) is telling me otherwise…

I don’t know but…

Try this site:

A 30 year old male smoker who is 5’ 10" and weighs a fit 150 lbs has a life expectancy of … 72 years.

The same guy who is not a smoker has a life expectancy of 79.2 years.

How much would our nonsmoker have to weigh to have a life expectancy of 72 years?

A: About 300 pounds. (That would give a life expectancy of 72.5 years).

So for somebody who is 30 years old and 5’ 10", smoking is like adding 150 extra pounds.

Bon appetit!

If you can get a definitive answer to this question, I will declare the person who gives it to be God.

I think there are just too many variables to figure out the answer.

I agree with BobT, you can show some statistics in general but you can’t really say which of the two of you has a better chance of living to be 70, 80, or even 90 years old.

Excessive exercise and excessive sports playing can actually drastically reduce life expectancy, for example.

It would also be worth asking which of these has more of an adverse effect on your health and quality of life right now.

The evidence that vigorous exercise, per se, does anything at all to extend life is pretty thin.
The evidence that cigarette smoking decreases lifespan is overwhelming.
The evidence that morbid obesity decreases lifespan is pretty good for most population groups. If you are just a little fat, hard to prove that’s very bad, especially if your other numbers–BP and sugar especially–are good.
The evidence that exercise can help with the obese-prone over the long run is pretty thin.
The evidence that serious exercise–hours of high-cardio/week, marathons, etc is bad for you is pretty good.
The evidence that if you stop smoking after 55 you’ll be much better off than if you had never smoked is pretty thin.
Generally speaking, moderate activity–think stairs instead of escalators and a nice brisk daily walk–is probably good for you.

Each of these might create its own Great Debate, but the short answer is the smoker dies before the sedentary, all else being equal. From an economic standpoint, thank goodness for smokers. They lead productive lives and then have the decency to croak before they suck up thirty years of government-paid pensions.

Just from my own experience:

I know lots of really, really old smokers.

I don’t know any really, really old obese people.

I’ve seen the warning on cigarette packs.
I’ve never seen any warning on an ice cream bar.
If I had to choose…fat beats cancer or emphysema.
(After all I could always call Jenny.)

Oh c’mon.

I’ve seen dose-response claims regarding cigarettes: they are backed by epidemiological evidence.

Here’s an article on exercise:

Bow down before me!
I’ve already shown a site suggesting a 7 year loss of life-years due to smoking.

This report maintains that exercise can add 1.5 - 3.5 years to your life expectancy.

7 > 3.5 > 0.

Smoking loses. TV doesn’t win.

So eat less, exercise more, stop smoking and wear a seatbelt already!

Cite?
Your generalizations don’t sound right. You are saying athletes are more likely to be in poor health than the average Joe Shmoe.
I do several hours of biking a day and I’m in excellent health. You don’t get any serious fitness by doing a brisk daily walk.

Exercise is good, whether you smoke or not.

Consider the cite that gave average life expectancies. The non-smoker had six extra years.

Ah, but what kind of years, think of that? Years when you are in a walker? Years when you are in a nursing home with someone changing your diapers? Years when all you can do is sit in front of the TV?

Okay, I retract that last one.

But me, when I can’t move, I’m done. Exercise keeps me moving.

I think you’re kidding yourself here. Very few people have the luxury of being that sedentary, and many of the ones who do would rather exercise a little now and then.

H.N. Suze:
Quality Adjusted Life Years (or QALYs) and Quality of Well Being (QWB) are two measures used to adjust for changes in morbidity (or ill-health) in addition to mere years of life lost.

An abstract for an article on the effects of smoking on QALYs and QWBs is here. Unfortunately, I can’t tell how meaningful the study is without reading the actual article and working out their quality of life measure. FWIW though, the authors report that, “A greater portion in the loss in QALE is attributable to quality of life than to shorten life expectancy.”

I have done graphic work (charts, graphs, slide shows, etc.) for some of the top cardiologists in the country. Whenever risk factors are mentioned, smoking is invariably at the top of the list, followed by diabetes and obesity. Many cardiac surgeons will refuse to perform non-emergency surgery on a smoker.

But who is more likely to get killed in a car accident or meet some other premature end?

“Athletes” is a pretty broad term. If you use it to include the NFL players, for instance, you get some grim longevity numbers–say 55 years or so of life expectancy. Beating up your body is not necessarily sound health policy. I realize you are not putting forward the “Not For Long” players as your case study here, but any time you include really vigorous exercise you have to include the effects of wear and tear on joints and soft tissue, not to mention the wear and tear of bicycle accidents…

I certainly should not have used “vigorous” without specifiying that I mean the real exercise fanatics who train for hours a day at high output–not the guy that exercises 30 mins a day to 80% capacity.

You do get significant benefit from a “brisk daily walk”; perhaps even more benefit if you are willing to run 30 minutes a day 5 days a week.

Franco and others noted that this and other studies show that people do not have to be exercise fanatics to reap the benefits. “What we’re talking about is small changes,” said James Hill of the University of Colorado in Denver. “We’re telling people to get out and walk more. Fifteen, 20 or 30 minutes of walking each day is probably enough.” http://sfgate.com/cgi-bin/article.cgi?file=/c/a/2005/11/15/MNG29FOAJP1.DTL

But stepping up to hours of vigorous activity a day? I need that cite from you if you are claiming longevity for it.

Well trained athletes are a group already selected out for some degree of “health” so the trick is to prove their training causes their good health versus their genes enabling their training. If you were in poor health would you be able to exercise several hours a day?

Certainly having Mr. Schmoe step up to marathons and the like may be counterproductive: http://circ.ahajournals.org/cgi/content/abstract/114/22/2325

The problem with studying exercise and its role in health and longevity is the post hoc ergo propter hoc fallacy that creeps in because people with assorted types of crummy health don’t exercise. There is a notion out there that if you took two random groups at any age and prescribed (and could enforce) exercise for one and couches for the other that there would be a significant benefit which is more or less linearly related to the quantity of exercise. This is quite a different thing than what has been shown, which is that folks who exercise regularly are healthier and live longer than those who don’t. I’d expect to see less heart disease in marathoners (Mr Fixx excepted) than in non-marathoners because people with heart disease are less likely to be able to run marathons. That is not proof that running marathons diminishes heart disease. It may or it may not.

Anecdotally, and I am ignorant of whether anyone has looked at it, I am very surprised by the relatively paucity of older runners in marathons. Running has been so popular for so long, that if it’s that good for you, where are the 70 and above runners in a typical race? Fewer than 50 guys over 70 in last year’s Chicago marathon?

If smokers are less likely to die in car accidents (a dubious proposition) that would be reflected in an epidemiological study of the sort I linked to above.

A more serious problem would involve confounding factors. For example, if smokers tended to live more in urban areas, higher exposure to air pollution and other urban problems might cause the unskilled researcher to blame all of these harms on smoking alone.

But such issues are easily handled with -wait for it- multivariate analysis which is alas outside of the scope of a general interest message board.

So put it another way: insurance companies are greatly interested in these sorts of questions. So there’s incentive to get the details right.