Avoid a slow death✳

Quit smoking—the earlier, the better

In US studies, smokers lived on average more than 10 years less than nonsmokers. Quitting before age 40 eliminates roughly 90% of the extra death risk caused by continued smoking. The earlier you quit, the more years you gain. If you keep smoking after a fracture, the bone is more likely to fail to heal, so don’t smoke until the bone has healed.

Don’t smoke at home or in the car, and don’t let guests smoke indoors

In 2004, approximately 600,000 people worldwide died from inhaling others' smoke, nearly 30% of whom were children. People exposed to secondhand smoke are more likely to develop hypertension, heart disease, and stroke. Inhaling smoke at home is more harmful than exposure away from home.

Don't Just Rely on Willpower to Quit Smoking, Get Medication First: The Success Rate of Taking Varenicline Can More Than Double

The proportion of people who successfully quit smoking while taking varenicline is more than twice that of those taking a placebo. Using nicotine replacement therapies, such as nicotine patches or gum, is about 50% higher than not using medication. Using patches and gum together can increase the rate by an additional more than 20%.

Pick a quit date and stop smoking on that day — don’t taper gradually

Many people try to cut back a little each day until they reach zero. Yet after six months, only 15.5% of those who gradually reduced their intake stayed smoke‑free, compared with 22% of people who set a quit date and stopped all at once. So it’s better to pick a date and quit completely on that day.

Visit a smoking cessation clinic or call 12320 to find local services

Medication and "having someone check in on you regularly" are two different things, but together they are even more effective. For those who take medication while having a dedicated person following up, the success rate of quitting is nearly twice that of those who only receive a single brief piece of advice. Phone calls also count: smoking cessation hotlines that proactively follow up multiple times see success rates increase by 25% to nearly 40%.

Only consider e‑cigarettes if you’ve already tried quitting; non‑smokers should avoid them

Switching from cigarettes to nicotine-containing e-cigarettes results in approximately 60% more people successfully quitting compared to using nicotine replacement therapies; this conclusion is very reliable. However, long-term safety data is insufficient, and they cannot be considered harmless. These trials compare people who intend to quit smoking; those who do not smoke should not use them.

Not drinking sugary drinks — even switching to sugar-free ones doesn’t help

In studies from the United States, people who drink at least two servings of sugary drinks daily have a mortality risk approximately 20% higher than those who drink almost none. Those drinking one to two servings daily also have a risk more than 10% higher. No benefit from sugar-free alternatives was observed in these data: people who drink at least two cups of sugar-substitute drinks daily actually have a risk approximately 25% higher.

Not chewing betel nut

The probability of death during the same period for people who chew betel nut is about 20% higher than for those who do not. The risks of diabetes and metabolic syndrome are about 50% higher. The risks of oral cancer and esophageal cancer must be calculated separately.

Switch household salt to low‑sodium (potassium‑rich) salt

In rural China, a study followed people who had previously had a stroke or who were aged 60 and above with hypertension for nearly five years. Replacing household salt with a low-sodium substitute was associated with about 12% lower mortality and about 14% fewer strokes.

Brush teeth carefully, clean between teeth once every day, and see a dentist if you lose a tooth

In a Japanese study, people who used floss or interdental brushes had about 10% lower mortality risk. Older adults with no teeth or fewer than 20 teeth also had clearly higher mortality risk. Electric toothbrushes remove about 10–20% more plaque than manual brushes and leave gums a little less inflamed, but the practical importance of this difference remains unclear.

Walking 7,000–8,000 steps per day, or accumulating 150–300 minutes of brisk walking each week

People who walk roughly 7,800 steps daily have a mortality risk roughly 45% lower than those walking only 3,500 steps. The same pattern holds when measured by time: those who engage in 150–300 minutes of brisk walking weekly face about 30% lower risk than inactive individuals. Beyond a certain threshold, further increases bring little extra benefit; for people aged 60 and older, 6,000–8,000 steps per day is sufficient. Meeting either the step-count or duration target is enough.

Regular lipid profile testing in adulthood: every 2 to 5 years before age 40, and annually from age 40; take antihypertensive and lipid-lowering medications regularly as prescribed for hypertension or hyperlipidemia, and do not stop on your own

For every 10 mmHg reduction in systolic blood pressure, the probability of death decreases by approximately 13% and the probability of stroke decreases by approximately 27%. When statins reduce low-density cholesterol by 1 unit, the probability of death decreases by approximately 10%. People who take medication on time have a 30% to 45% lower probability of death than those who frequently miss doses. For lipid profiles, test every 2 to 5 years before age 40, and annually starting from age 40.

Getting about 7 hours of sleep each night with a consistent schedule

For people who consistently sleep less than 7 hours, the probability of death during the same period is approximately 10% higher. The more irregular the routine, the higher the risk. Compared to the group with the most irregular routines, others have a risk that is 20% to nearly 50% lower. The irregularity of the routine is a better indicator of mortality risk than the duration of sleep.

Regularly play racket sports such as tennis, badminton or table tennis

People who regularly play tennis, badminton, or table tennis have about half the risk of dying compared to non-players. Their risk of dying from cardiovascular causes is roughly 56% lower. Swimmers had about 28% lower all-cause mortality risk. No difference was detected for running or football in this data set.

Accumulating brief bouts of strenuous activity like stair climbing or brisk walking to total 4–5 minutes per day

For individuals who do not exercise regularly, performing just three 1–2 minute bouts of strenuous activity each day can reduce their overall risk of death by roughly 40% compared to those who do none at all. Their risk of dying from cardiovascular causes also drops by nearly half. Such strenuous activities include stair climbing and brisk walking.

30–60 minutes of strength training per week

People who engage in 30–60 minutes of strength training each week have a 10–20% lower risk of dying compared to those who don’t train at all. Training beyond this amount won’t bring any extra benefit. Combining strength training with aerobic exercise yields the best results.

Looking for the full analysis? Explore the long reads · Keeping your muscles strong, one workout and one meal at a time

Don’t sit for too long at a time — get up and move every now and then

People who sit the longest have a mortality risk more than 150% higher compared to those who sit the least. Sitting continuously for long stretches adds extra risk on top of that. However, if you get 60–75 minutes of moderate-intensity activity each day, this extra risk from prolonged sitting is largely offset.

Eat less processed meat (ham, bacon, sausages, luncheon meat)

People who eat the most ham, bacon, sausages, and similar processed meats have a roughly 20% higher chance of dying during the same period compared to those who eat the least. For every extra serving of processed meat consumed daily, that risk rises by another 20%.

Drink less or no alcohol

After consuming 100 g of pure alcohol per week, the more one drinks, the earlier they tend to die. 100 g of pure alcohol is roughly equivalent to 2.5 L of beer. At age 40, people who drink 100–200 g per week lose about half a year of life expectancy; those drinking 200–350 g lose 1–2 years; and those drinking over 350 g lose 4–5 years. Overall, the healthiest amount to consume is none at all.

People who drink daily and experience tremors and palpitations when they stop should not try to quit on their own

People who drink large amounts every day will experience withdrawal symptoms if they stop suddenly. Mild symptoms include hand tremors, sweating, palpitations, and insomnia; severe cases may involve convulsions or the onset of delirium tremens, which is a potentially life-threatening emergency. A Norwegian study tracked over 30,000 people, and among those who had experienced delirium tremens, 8% died each year thereafter. If you want to quit, go to the hospital first and clearly state how much you drink daily.

To drink less, first tally how much you drink each week, then chat briefly with a doctor

A doctor can spend a few minutes reviewing your weekly alcohol intake, explaining the associated risks, and helping you set a realistic goal. After a year, people following this approach typically cut their weekly consumption by about 20 grams of pure alcohol — roughly equivalent to half a liter of beer. Longer consultations do not bring any additional benefits. For those already struggling with heavy drinking, two medications have been proven effective abroad: for every 12 patients treated, roughly one person stops drinking excessively after treatment.

Eating a small handful of nuts daily

People who regularly eat nuts have roughly 20% lower mortality rates than those who don’t. Even eating nuts just once a week yields a 10% reduction in risk. The greatest benefit is seen when intake reaches a daily handful.

Swapping some red meat for fish or poultry

Eating two extra portions of processed or red meat per week increases the risk of death by approximately 3%. If replaced with the same number of portions of fish or poultry, no increase is observed. The effect of this meat substitution in this section is relatively small, belonging to the category of something to swap whenever convenient without needing to force it.

Swap some refined rice and flour for whole grains

People who eat an extra 90 g of whole grains daily have a roughly 17% lower risk of dying during the same period. That amount equals about three servings. The risk continues to drop when intake rises to around 200 g per day.

Drinking tea more than three times a week

People who regularly drink tea have a roughly 15% lower risk of dying. Starting at age 50, they can expect to live 1.26 years longer on average, and 1.41 extra years without developing any cardiovascular diseases.

Drink three to four cups of coffee a day, keep total caffeine at or below 400 mg, and skip sugar and cream toppings

People drinking three to four cups of coffee daily had about a 17% lower risk of dying during follow-up than non-drinkers. In another study, those drinking mainly in the morning had about a 12% lower risk, while all-day drinkers showed no clear difference. Caffeine content varies greatly by cup, so keep the daily total at or below 400 mg.

Eating 5 servings (about 400 g) of fruits and vegetables daily

Eating 200 g more fruits and vegetables daily reduces the risk of death by approximately 10%. For those who eat 5 servings every day, the risk is approximately 13% lower than those who eat only 2 servings. In the US study, eating more than this will not result in a lower risk.

Eat fewer ultra-processed foods (chips, instant noodles, pastries, ready meals)

People who consume the most ultra-processed foods have a roughly 20% higher risk of dying during the study period compared to those who eat the least, and a 50% higher risk of dying from cardiovascular disease. However, this evidence is rated as low certainty, so these figures should be interpreted with caution.

Switching from coal and wood to electricity or gas for cooking and heating

People who cook with coal or wood face roughly a 10% higher risk of dying compared to those using electricity or gas. For those who heat their homes with coal or wood, the risk is about 14% higher. Those who have already switched to cleaner fuels have a mortality risk that is 13%–33% lower than those still relying on coal or wood.

Let hot drinks cool down before drinking; avoid tea, soup, and coffee that are piping hot

In a study from a high-incidence area of Iran, very hot tea was associated with about 8 times the risk of esophageal squamous cell carcinoma, a type of esophageal cancer, compared with warm tea. Even “hot” tea was associated with about twice the risk. Drinking within two minutes of pouring was associated with about 5 times the risk of waiting at least four minutes.

Getting some sun during the day — don’t stay out of the light all the time

In a study from Sweden, women who deliberately avoid the sun have an expected lifespan 0.6 to 2.1 years shorter than those who get the most sun exposure. Non-smokers who avoid the sun have a lifespan similar to smokers who get the most sun exposure.

Keeping BMI between 20–25; losing weight if overweight

The risk of death is lowest in the BMI 20–25 range. When BMI reaches 27.5–30, the risk is approximately 20% higher; at 30–35, it is approximately 45% higher; and at 35–40, it is about 90% higher. For East Asians with a BMI of 25 or higher, for every increase of 5, the risk is approximately 40% higher.

Eating chili peppers four or more times per week

In a study from Italy, people who ate chili peppers at least four times a week had a risk of death that was approximately 23% lower than those who ate them rarely, and cardiovascular death was approximately one-third lower.

Drinking one or two servings of milk or yogurt daily

People who consume two or more servings of milk or yogurt each day have a roughly 17% lower risk of dying compared to those who do not drink any.

No need to quit eggs; within one per day is fine

Eating half an extra whole egg per day increases the risk of death by approximately 7%. Replacing this half egg with egg whites, fish, poultry, or nuts actually results in a lower risk of death. However, another set of studies found no apparent link to cardiovascular disease within the limit of one egg per day, so there is no need to abstain from eggs.

Take baths whenever you can — don’t limit yourself to showers

In a Japanese study, people who soaked in a bathtub almost every day had approximately 28% lower risk of cardiovascular events and approximately 46% lower risk of cerebral hemorrhage compared to those who bathed less than twice a week.

Keep naps under 30 minutes—no longer than an hour. If you regularly need a one- or two-hour nap to get through the day, it’s time to see a doctor

People who nap for less than an hour show no increase in mortality or chronic disease risk, and their mental clarity actually improves. In contrast, those who nap for over an hour face roughly a 30% higher risk of coronary heart disease, and about a 20% higher risk of diabetes and obesity. So set that alarm and wake up after half an hour. If you find yourself needing a one- or two-hour nap every day just to function, that’s a clear sign you should get a medical check-up.

Catch up on sleep the night after a sleepless night — don’t wait until the weekend

People who get less sleep than they need and fail to make it up the following night have roughly a 15% higher risk of mortality compared to those with regular sleep patterns. Those who are severely sleep-deprived and still don’t catch up face a 42% higher risk. For people who do make up the lost sleep, no such elevated risk is observed. So, if you stay up late, go to bed early the next night.

The longer you work night shifts, the higher your cardiovascular risk — switch if you can

For those working night shifts, cardiovascular disease is approximately 13% higher, and cardiovascular mortality is approximately 27% higher than for those not working night shifts. Furthermore, the risk increases with duration: for every additional 5 years of night shifts, cardiovascular disease increases by approximately 7%. Therefore, this calculation is based on years of service; if a shift change is possible, do it as early as possible.

Buy pre-packaged cooking oil with an SC code; avoid bulk, unregulated homemade peanut oil

When peanuts get damp and moldy, they produce aflatoxin, a confirmed human carcinogen that primarily harms the liver. After Guangzhou tightened regulations on small-scale oil producers, among local residents who regularly consumed homemade peanut oil, the proportion with abnormal liver function fell by roughly 35%. In Guangxi, low birth weight and preterm birth were more common among babies of women who ate homemade peanut oil.

Replacing lard and butter with vegetable oils for cooking: you don’t need to switch oils for health reasons, nor should you expect flaxseed oil to protect your heart

Reducing the intake of saturated fats such as lard and butter and replacing them with vegetable oils reduces the risk of events like heart disease and stroke by approximately 17%, but no change in overall mortality risk was observed. Increasing the intake of the main components of soybean oil and corn oil showed no apparent benefits or harms. Consuming more flaxseed oil also showed no decrease in the risk of heart disease.

Turn on the range hood while stir-frying and deep-frying, from the moment you light the stove until the cooking is done

Non-smoking Chinese women who rarely or never use a range hood while cooking face roughly twice the risk of developing lung cancer compared to those who use one regularly. Living in a kitchen with poor ventilation also raises this risk by about 50%, with the effect being most pronounced among households that burn coal.

If hot flashes and night sweats around menopause disrupt your life, see a gynecologist to assess hormone therapy; do not just endure them or buy medication yourself, and do not use it to prevent heart disease

For hot flashes and night sweats around menopause, hormone therapy reduces the number of hot flashes by about 75% compared with placebo. The trade-off is a small increase in breast cancer, blood clots, and stroke: about 8 additional cases of each per 10,000 women per year. All-cause mortality did not increase among those who started at ages 50 to 59. It must not be used to prevent heart disease or dementia.

If you already wanted a dog, count the daily walk toward your steps — don’t get a dog just for longevity

The probability of death during the same period is on average about one-quarter lower for dog owners, and even lower for those who have had coronary heart disease. However, after adjusting for other differences, large studies in the UK and Norway show no difference, and no association is found with owning cats either. Therefore, do not get a dog specifically for longevity; if you already want one, treat daily dog walking as part of your walking exercise.

If diagnosed with prediabetes—high blood sugar below the diabetes threshold—delay diabetes through eating less, losing weight, and moving more, and recheck blood sugar every six months

For people with high blood sugar who do not yet have diabetes, eating less, moving more, and losing some weight can reduce diabetes risk by 30%–60%. In China's Da Qing trial, followed for 30 years, those making these changes had about one-quarter lower mortality and lived about a year and a half longer on average. Similar US and Finnish trials, however, did not detect a mortality difference.

Discard the whole package if peanuts, corn, nuts, rice, or flour go moldy; do not pick out the moldy pieces and eat the rest, and spit out bitter-tasting nuts immediately

Moldy peanuts and corn can develop aflatoxins, which can cause liver cancer. In a Shanghai study, people with detectable urinary aflatoxin markers had about 3.4 times the liver cancer risk of those without them. People with both hepatitis B and detectable toxin markers had about 59.4 times the risk of those with neither. Stir-frying, boiling, and deep-frying do not easily remove these toxins.

Avoid raw freshwater fish and shrimp dishes, including sashimi, raw-fish congee, and drunken shrimp; if you have eaten them regularly, get tested for liver flukes and take praziquantel as prescribed if infection is found

Eating raw freshwater fish or shrimp can transmit liver flukes, parasites known to cause cancer. Infected people have about four to five times the risk of bile duct cancer compared with uninfected people. Vinegar, alcohol, and mustard cannot reliably kill them. Two days of medication can cure over 90% of infections.