How Much Smoking Damage Can You Reverse If You Quit?
There are Steps Ex-smokers Can Take to Speed-up the Healing, But at Least Some of the Damage is Likely Permanent
— By Tom Murphy | July 23, 2026 | The Wall Street Journal (WSJ)
Congratulations if you’re among the country’s nearly 56 million ex-smokers. Many health benefits are coming your way—some of them within just a few minutes.
Over the long term, though, the health picture gets a lot more complex. Some problems caused by smoking take decades to clear up, and certain lung damage can’t be fixed. Plus, a higher risk for lung cancer never completely fades.
Even so, there are plenty of steps ex-smokers can take to boost the benefits from quitting, from changing their diet to beefing up their exercise regimen. Even if restoring pristine lung condition isn’t an option, doctors say quitting still matters—both for health and quality of life.
“Quitting is absolutely one of the most powerful things that someone can do for their health at any stage, at any time,” says Eric Singhi, a Thoracic Medical Oncologist with the MD Anderson Cancer Center in Houston.
Ex-smokers now outnumber the country’s 27 million smokers two to one, according to an American Lung Association analysis of federal health data. And there is no simple answer to the question of how much they will heal after quitting. That depends on how many cigarettes someone smoked, for how long and what part of their body was damaged.
In general, screening guidelines indicate that a more intense smoking habit is a bigger concern. But “there’s really no safe level of smoking,” says Singhi. “Even any occasional or social smoking does increase the risk of lung cancer, lung damage compared to someone who has never smoked.”
Still, all smokers will start seeing some benefits immediately. Any time someone stops smoking—even temporarily—their heart rates can drop to normal levels in around 20 minutes, according to the American Lung Association. Carbon-monoxide levels in the blood fall within hours.
The benefits get even stronger the longer people stay away from smoking. Cilia, tiny hairs that clear mucus out of the lungs, resume working within weeks, prompting coughing that clears the lungs. Ex-smokers gain a slight increase in lung function weeks after quitting as swelling and inflammation settle down.
Heart-disease risk drops rapidly in the first weeks and months after quitting, says David Hill, a pulmonologist and chair of the American Lung Association’s board of directors.
“We don’t think of smoking as a systemic illness, but it is,” he says.
Call It Quits: Ratio comparing mortality rates of former and current smokers to never smokers, by cause, Cardiovascular (Left)! Cancer (Left)! Source: JAMA Internal Medicine; Blake Thomson, Stanford University School of Medicine; Farhad Islami, American Cancer Society. *Confidence Interval
Melissa Reeves quit a pack-a-day habit more than a year ago and has seen many benefits. Her senses of taste and smell have rebounded, and she gets less winded on hikes with her grandchildren.
“There’s definitely some healing going on,” the 65-year-old Danville, Ind., resident says.
Some health improvements take time. Smoking leads to the buildup of plaque on artery walls, and it can take 20 or 30 years to clear, says Aruni Bhatnagar, a professor at the University of Louisville School of Medicine who researches the impact of tobacco use.
Over the long term, a healthy lifestyle is critical to repairing lung damage. A 2022 study of more than 150,000 former smokers compared those who did and didn’t stick to recommendations for maintaining body weight, staying physically active, eating a healthy diet and limiting alcohol consumption.
The study, from JAMA Network Open, found that people who reported the highest adherence to those recommendations had a 27% lower risk of death from all causes compared with those who didn’t follow the recommendations closely.
Regular exercise like running or walking strengthens the heart and reduces the chances of dying from cardiovascular disease. It also builds respiratory muscles—your lungs can’t move without them—and doctors say that helps reduce smoking-related symptoms like shortness of breath. It also can slow the loss of lung function.
Exercise also boosts antioxidant enzymes in the body, which protect cells from damage. Augustine Lee, a pulmonologist with the Mayo Clinic’s Jacksonville, Fla., campus, says a lifestyle and diet that promote antioxidant buildup is associated with less heart disease and cancer. Foods filled with antioxidants include dark green vegetables, blueberries, nuts, green tea or fish.
What’s more, staying hydrated helps flush toxins, keeps organs functioning optimally and thins mucus, making it easier for lungs to stay clear.
“The combination of quitting smoking, plus exercise plus a healthy diet all contributes to better lung function,” Lee says.
Doctors say there are several other things ex-smokers can do to keep major problems at bay and help their body recover. They should avoid secondhand smoke and have their homes tested for radon gas. “A lot of people don’t know that radon gas is the second-leading cause of lung cancer in the U.S.,” Singhi says.
Ex-smokers should also avoid switching to vaping instead of smoking. “The only thing you should be breathing into your lungs is clean air,” Hill says. “Vaping and e-cigarettes have been marketed as less harmful, but we don’t have that data.”
But it is also important for ex-smokers to understand the limits they face. While an ex-smoker’s lungs can clear out after quitting, one important element doesn’t recover. Smoke kills alveoli, the lung’s tiny air sacs that allow the body to take in oxygen and remove carbon dioxide. Ultimately, if enough alveoli die, the smoker winds up with an irreversible condition like emphysema that makes breathing difficult.
Every Breath: Ratio comparing mortality rates of former and current smokers to never smokers from respiratory causes. Source: JAMA Internal Medicine; Blake Thomson, Stanford University School of Medicine; Farhad Islami, American Cancer Society. *Confidence Interval
“Once the airways are scarred up, there is no going back,” says Lee.
Smoking also doubles the natural rate of decline in lung function. “You can get short of breath and cough even years after smoking just because of that natural loss of lung function,” Lee says.
What’s more, the toxic chemicals in smoke damage lung-cell DNA, which acts like an instruction manual telling the cells how to behave. Some of those damaged cells die, but those that remain can trigger abnormal cell growth, or cancer.
“We actually have data that show us that decades from when you quit smoking, the risk can still be almost three to four times higher than someone who has never smoked,” Singhi says.
Doctors also see preventive medicine as a key to preserving longevity. Singhi urges former heavy smokers to have annual lung-cancer screenings. Insurance may cover the procedures for people who averaged a pack a day or more for years.
“Screening is what helps us catch lung cancer early when it’s the most treatable,” he says.
Ex-smokers also should seek help if they develop shortness of breath or a cough that lasts more than three months. Those may be early signs of a problem like chronic obstructive pulmonary disease. That can’t be cured, but it can be managed, especially if care starts early.
While all damage from smoking may not be erased, quitters can add healthy years to the end of their life, which can be just as important to them as how long they live.
Patients sometimes tell Lee that they enjoy smoking, and they just plan to do it until they die. The problem, the physician says, is that smokers often don’t die quickly.
They can wind up with a form of chronic obstructive pulmonary disease like emphysema, tethered to oxygen as their health declines.
“You can’t walk, go outside, every mild cold becomes a major event where you could go into respiratory failure,” he says. “It can be a difficult death.”