The rate of smoking among nurses fell about 75% between 1976 and 2003–but the consequences of the habit are still devastating, a new report found.

In America’s bicentennial year, 33.2% of nurses reported a tobacco habit. Twenty-seven years later, that number had dropped to 8.4%, according to an analysis by the University of California, Los Angeles, School of Nursing. Snuffing out the smoke has made a big difference in the longevity of nurses, especially those in their late 70s, report authors note. But mortality rates among nurse smokers–even ex-smokers–are still much higher than among those who never started.

Nurses who have quit smoking still experience a mortality rate 1.5 times higher than average, and those who have yet to quit are 2.3 times more likely to die by the time they reach their late 70s, the research reveals. The study was compiled using data from a decades-long survey of 237,648 female registered nurses about their health. The survey was started in the 1970s at Brigham and Women’s Hospital. The full UCLA report appears in the November/December issue of Nursing Research.