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Modification of the Effect of Vitamin E Supplementation on the Mortality of Male Smokers by Age and Dietary Vitamin C (PDF) 

In conclusion, our subgroup analyses of the ATBC Study cohort support the conclusions of meta-analysis of controlled trials (4–6), in that vitamin E supplementation seems ineffective or harmful for middle-aged male smokers. Evidently, in people younger than age 65 years, taking vitamin E supplements should be strongly discouraged until clear evidence emerges that some population groups of younger or middle-aged people benefit. On the other hand, our study indicates that vitamin E supplementation may lead to beneficial effects in some subgroups of old people, and this possibility should be investigated by using a factorial design with vitamin C supplementation. Finally, the substantial decrease in mortality with vitamin E supplementation among the older participants with high dietary vitamin C intake raises the question of whether the decrease in overall mortality is attributable to a single cause of death or a few causes, or whether it suggests a general decrease in frailty reflected in lessened mortality from diverse causes.

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