A 30-year follow-up study has revealed that non-smokers live happier and longer lives, free of the burdens of heart disease - a luxury not available to those who still swear by the cigarette.
The study, which included 54,000 men and women in Norway, was presented in Stockholm at EuroPRevent 2009.
Smoking, say the investigators, is "strongly" related to cardiovascular morbidity and mortality from various causes.
According to investigator Professor Haakon Meyer from the University of Oslo and Norwegian Institute of Public Health, the study's results provide a picture of the long-term, absolute "real life" risk.
Behind his conclusions lies a far-reaching follow-up study which began in 1974 with an invitation to every middle aged man and woman (aged 35-49) living in three counties of Norway to take part in a basic cardiovascular screening examination.
Over the next three decades deaths were recorded by linkage to the Norwegian population registry and, between 2006 and 2008, those surviving responded to a follow-up questionnaire. This allowed division of the participants according to their smoking status - never-smokers, ex-smokers, current smokers of 1-9 cigarettes a day, 10-19 cigarettes a day and more than 20 cigarettes a day (the last group referred to as "heavy smokers").
Results showed that, from the original 54,075 participants, 13,103 had died by the time of follow-up. But it was a significant finding that, of these, 45 percent of the heavy-smoking men had died during the 30 years, compared to just 18 percent of the never-smokers.
Similarly, 33 percent of the heavy-smoking women had died, but only 13 percent of the never-smokers.
"These results show what a tremendous impact smoking has on mortality. We are talking about very high numbers of people," Meyer said.
A similar pattern was seen in the cardiovascular incidence rates reported in the follow-up questionnaire. There were also strong associations found between smoking and stroke and diabetes.