There is good news for smokers,with an analysis of 20 years of data on the health of over 900 adults revealing that long-term use of traditional non steroidal anti- inflammatory drugs (NSAIDs), such as aspirin ibuprofen and naproxen, cuts the risk for oral cancer in smokers by half.

However, use of these pain relievers (with the exception of aspirin) for 6 months or more also doubled users' risks for cardiovascular death, according to collaborative research published online Oct. 7 by The Lancet.

The study was conducted by researchers at the Norwegian Radium Hospital and The National Hospital in Oslo; University of Science and Technology, Trondheim, Norway; NewYork-Presbyterian Hospital/Weill Cornell Medical Center in New York City; The University of Texas M. D. Anderson Cancer Center in Houston; and the University of Helsinki.

"Our findings highlight how a commonly used drug can have a benefit from the standpoint of cancer prevention but can also have side effects - in this case, an increased risk for cardiovascular death," said co-researcher Dr. Andrew Dannenberg, the Henry R. Erle, M.D., Professor of Medicine at Weill Medical College of Cornell University and Director of Cancer Prevention at NewYork-Presbyterian/Weill Cornell.

The findings "also support moves by the U.S. Food and Drug Administration, which recently mandated special 'black box' warning labels on all NSAID pain relievers except aspirin, warning consumers of potential cardiovascular side effects linked to long-term use," added lead researcher Dr. Jon Sudbx, a senior consultant in the Department of Medical Oncology and Radiotherapy at Norwegian Radium Hospital.

The new FDA-mandated labeling applies to both the over-the- counter and prescription versions of these drugs. The agency's decision followed earlier moves in 2004 and 2005, when two COX-2 enzyme-specific NSAIDs were withdrawn from the market - first Vioxx was voluntarily recalled by Merck in September 2004, and then the FDA ordered the recall of Bextra earlier this spring.

The findings were presented earlier this year at the annual meeting of the American Association for Cancer Research.

" In addition, Dr. Dannenberg and co-author Dr. J. Jack Lee, Professor of Biostatistics at the M. D. Anderson Cancer Center, stressed that although the data themselves were collected prospectively, the study remains a relatively small, retrospective effort. "It's tough to make sweeping generalizations until the results are confirmed by much larger, prospective trials," they said.

So, might long-term use of traditional NSAIDs still be right for some people ? According to the study investigators, a careful risk-benefit assessment is required, and that's a question best left to a patient and his or her doctor.