中国成年人吸烟与心血管疾病发病风险的关联及其性别差异分析

目的 分析中国成年人吸烟与不同心血管疾病发病风险的关联及其性别差异。方法 研究对象来自中国慢性病前瞻性研究,基线调查开展于2004年6月至2008年7月,剔除基线自报患有恶性肿瘤、冠心病、脑卒中的个体,最终纳入487 373名研究对象。随访人年数的计算从研究对象完成基线调查时开始,至最早出现以下任一事件的时间为止：心血管疾病（CVD）发病、死亡、失访或2015年12月31日。使用Cox比例风险模型计算吸烟行为特征和心血管疾病发病风险的关联。结果 研究对象平均随访8.9年。随访期间新发缺血性心脏病33 947人,急性冠心病事件6 048人,脑内出血7 794人,脑梗死31 722人。男性吸烟率（67.9%）远高于女性（2.7%）。与非吸烟者相比,吸烟能增加各类CVD结局的发病风险,风险效应值HR值 （95%CI）由大到小依次为急性冠心病事件1.54 （1.43～1.66）、缺血性心脏病1.28 （1.24～1.32）、脑梗死1.18 （1.14～1.22）、脑内出血1.07 （1.00～1.15）。当前吸烟者中,每天吸烟量和开始吸烟年龄与急性冠心病事件风险间的关联存在性别差异（性别交互作用P值分别为0.006、0.011）,主要表现为女性吸烟者风险高于男性。每天吸烟量和开始吸烟年龄与缺血性心脏病、脑内出血和脑梗死之间的关联均未见性别差异（性别交互作用P>0.05）。结论 吸烟能够增加各类CVD的发病风险,而女性吸烟者发生急性冠心病事件的风险远高于男性。     

北京60岁及以上老年人吸烟状况与死亡风险的关联研究

目的分析北京城乡老年人群吸烟状况与相关死亡风险间的关联。方法基于北京城乡老年人群健康综合研究2009—2014年的队列数据, 纳入符合标准的60岁及以上老年人群4 499名, 随访其生存与死亡结局。采用Cox比例风险模型分析吸烟状态、吸烟指数、戒烟年数与死亡风险间的关联。结果 4 499名研究对象年龄M(IQR)为70.00(10.00)岁, 其中男性1 814名(40.32%);从不吸烟者、戒烟者和现在吸烟者分别有69.50%(3 127/4 499)、13.20%(594/4 499)和17.30%(778/4 499)。多因素Cox回归分析结果显示, 调整人口社会学特征、生活方式等混杂因素后, 以从不吸烟者为参照, 戒烟者全因死亡风险增加30.6%[HR(95%CI):1.306(1.043～1.636)];现在吸烟者全因、恶性肿瘤和肺癌死亡风险的HR(95%CI)分别增加50.0%[HR(95%CI):1.500(1.199～1.877)]、80.3%[HR(95%CI):1.803(1.226～2.652)]和212.6%[HR(95%CI):3.126(1.626～6.01...     

安庆地区配偶吸烟与脑卒中发生风险的关系

目的评估中国安庆地区人群配偶吸烟和脑卒中发生风险的相关性。方法 1995-2005年基线调查中,通过问卷调查收集吸烟和其他相关变量。2010-2011年对基线人群进行随访收集脑卒中事件并进行核实。COX比例风险模型估计配偶吸烟与脑卒中的相关性。结果纳入分析16 706人,平均随访（7.0±2.2）人年,共收集231例脑卒中事件。调整性别、年龄、收缩压、体质指数（body mass index,BMI）、饮酒变量后,夫妻都吸烟人群发生脑卒中风险是夫妻都不吸烟人群的1.89倍（RR=1.89,95%CI：1.05～3.39）,本人吸烟与配偶吸烟对脑卒中的发生有交互作用（P=0.033）;本人吸烟配偶不吸烟人群与夫妻都不吸烟人群相比患脑卒中风险增加（RR=1.33,95%CI：0.93～1.90）,但差异无统计学意义。按性别分层本人吸烟与配偶吸烟的交互作用相对危险度男性为2.81（95%CI：0.62～12.85）、女性为1.04（95%CI：0.30～3.64）,表明无论男性还是女性本人及配偶都吸烟时可能增加本人患脑卒中风险。结论本研究证实夫妻都吸烟可增加脑卒中发生风险。     

中老年男性吸烟状况与心血管疾病发生风险的关联性

  目的  探讨中老年男性吸烟状况与心血管疾病(cardiovascular disease,CVD)及其亚型发生风险的关联性。  方法  本研究选取东风-同济(Dongfeng-Tongji,DFTJ)队列中基线未患冠心病(coronary heart disease,CHD)、中风、癌症、严重心电图异常的13 940名男性为研究对象。研究对象均完成了基线调查,包括问卷调查、体格检查、生化指标检查和血液样本采集。采用Cox比例风险回归模型进行关联性分析,计算风险比(hazard ratio,HR)和95%置信区间(confidence intervals,CI)。  结果  多因素调整后,与从不吸烟者相比,现在吸烟者发生CVD、CHD和中风的风险增加,吸烟指数≥ 40包年者发生CVD、CHD和中风的风险HR值分别为1.49(95%CI:1.32~1.68,P_trend=0.001)、1.40(95%CI:1.22~1.62,P_trend=0.026)和1.59(95%CI:1.26~2.00,P_trend=0.029),开始吸烟年龄 < 20岁者发生CVD和CHD的风险HR值分别为1.29(95%CI:1.06~1.58,P_trend=0.007)和1.30(95%CI:1.03~1.64,P_trend=0.010);与现在吸烟者相比,戒烟时长≥ 10年者发生CVD和中风的风险显著降低,HR值分别为0.80(95%CI:0.71~0.91,P_trend=0.017)和0.65(95%CI:0.50~0.84,P_trend=0.207)。  结论  吸烟能增加CVD、CHD和中风的发生风险,且吸烟指数越大或开始吸烟年龄越小,CVD发生风险越高。戒烟可降低CVD和中风的发生风险。     

2013年山东省18岁以上居民吸烟与戒烟行为现状分析

目的分析2013年山东省18岁以上成年人吸烟与戒烟行为的流行状况,为进一步采取控烟措施提供科学依据。方法采用多阶段分层整群随机抽样的方法,在山东省19个慢性病危险因素监测点,通过问卷调查的方式,共调查11 254名18岁以上居民,了解其吸烟状况和戒烟情况。经过复杂加权后,分析不同特征人群的吸烟和戒烟情况。运用SAS 9.3软件进行χ~2检验和方差分析。结果调查对象现在吸烟率为24.02%,经复杂加权后,山东省18岁以上居民现在吸烟率为23.55%(95%CI:21.57%~25.53%),男性现在吸烟率为45.77%(95%CI:41.81%~49.73%),远高于女性现在吸烟率(1.32%,95%CI:0.42%~2.23%)。男性每日吸烟率为41.05%(95%CI:37.20%~44.91%),远高于女性每日吸烟率(1.04%,95%CI:0.40%~1.68%)。男性每日吸烟量为17.45支(95%CI:16.13~18.78支),高于女性(13.54支,95%CI:10.44~16.66支)。男性开始吸烟年龄为20.16岁(95%CI:19.67~20.65岁),早于女性(28.21岁,95%CI:23.22~33.20岁)。男性成功戒烟率为12.52%(95%CI:10.30%~14.74%),女性为14.21%(95%CI:3.13%~25.29%)。结论山东省成年男性吸烟率高,开始吸烟年龄早,戒烟成功率低,亟需出台更为具体的控烟政策法规。     

中国10个地区成年人慢性肾脏病流行情况及其生活方式影响因素

目的描述中国慢性病前瞻性研究(CKB)项目人群的慢性肾脏病(CKD)分布, 分析生活方式与CKD发病风险的前瞻性关联。方法数据来源于CKB基线调查及随访监测(截至2018年12月31日), 描述CKD发病的地区和人群分布差异, 使用Cox比例风险回归模型分析生活方式因素与CKD的关联。结果研究纳入505 147名研究对象, 平均随访11.26年, 期间共有4 920例发病病例, 发病率为83.43/10万人年, 肾小球肾病为最主要亚型。CKD发病率在城市、男性、年龄≥60岁人群中更高, 分别为87.83/10万人年、86.37/10万人年、132.06/10万人年。相比于从不或偶尔吸烟者, 当前吸烟男性CKD风险增加(HR=1.18, 95%CI:1.05～1.31)。以非肥胖人群为参照组, 由BMI判定的全身性肥胖(HR=1.19, 95%CI:1.10～1.29)和腰围判定的中心性肥胖(HR=1.27, 95%CI:1.19～1.35)均与更高的CKD发病风险相关。结论 CKB项目人群CKD发病率存在明显的地区和人群差异, 且其发病风险受到生活方式多因素的影响。     

两家工厂工人吸烟行为与烟瘾的调查

目的 调查工人的吸烟行为和烟瘾及戒烟意向,为开展控烟工作提供科学依据.方法 通过问卷调查,应用横断面调查方法对江苏省2家工厂的336名工人进行调查;烟瘾调查与评价采用国际问卷(Fagerstrom Test for Nicotine Dependence,FIND);吸烟、烟瘾与某些影响因素的相关性分析采用logistic回归分析.结果 男性260人,吸烟率为69.2%,目前吸烟率为64.6%(168人),戒烟者占总吸烟者的6.7%;女性均为从不吸烟.年龄较大、文化程度较低或一线生产工人的吸烟率较高,与朋友或吸烟者在一起、在家或休闲时吸烟较常见,63.0%的吸烟者觉得戒烟不难(自评戒烟难度30分以下),目前想过戒烟的占44.4%.吸烟者认为吸烟可引致肺癌和冠心病的比例分别为92.9%和86.1%,认为吸二手烟能引致肺癌和冠心病的比例分别占89.9%和83.3%.自我评价戒烟的难度与尼古丁依赖性明显相关,与自评＜30分比,自评30～60分和＞60分的吸烟者尼古丁依赖性的OR值(95%CI)分别为2.03(0.47～8.68)和9.90(3.09～31.75).结论 男性工人的吸烟率仍然很高,但轻度烟瘾的占大部分,且自评戒烟难度不大,现时是开展并推动工人戒烟的良好时机.     

两家工厂工人吸烟行为与烟瘾的调查

目的 调查工人的吸烟行为和烟瘾及戒烟意向,为开展控烟工作提供科学依据.方法 通过问卷调查,应用横断面调查方法对江苏省2家工厂的336名工人进行调查;烟瘾调查与评价采用国际问卷(Fagerstrom Test for Nicotine Dependence,FIND);吸烟、烟瘾与某些影响因素的相关性分析采用logistic回归分析.结果 男性260人,吸烟率为69.2%,目前吸烟率为64.6%(168人),戒烟者占总吸烟者的6.7%;女性均为从不吸烟.年龄较大、文化程度较低或一线生产工人的吸烟率较高,与朋友或吸烟者在一起、在家或休闲时吸烟较常见,63.0%的吸烟者觉得戒烟不难(自评戒烟难度30分以下),目前想过戒烟的占44.4%.吸烟者认为吸烟可引致肺癌和冠心病的比例分别为92.9%和86.1%,认为吸二手烟能引致肺癌和冠心病的比例分别占89.9%和83.3%.自我评价戒烟的难度与尼古丁依赖性明显相关,与自评＜30分比,自评30～60分和＞60分的吸烟者尼古丁依赖性的OR值(95%CI)分别为2.03(0.47～8.68)和9.90(3.09～31.75).结论 男性工人的吸烟率仍然很高,但轻度烟瘾的占大部分,且自评戒烟难度不大,现时是开展并推动工人戒烟的良好时机.     

两家工厂工人吸烟行为与烟瘾的调查

目的 调查工人的吸烟行为和烟瘾及戒烟意向,为开展控烟工作提供科学依据.方法 通过问卷调查,应用横断面调查方法对江苏省2家工厂的336名工人进行调查;烟瘾调查与评价采用国际问卷(Fagerstrom Test for Nicotine Dependence,FIND);吸烟、烟瘾与某些影响因素的相关性分析采用logistic回归分析.结果 男性260人,吸烟率为69.2%,目前吸烟率为64.6%(168人),戒烟者占总吸烟者的6.7%;女性均为从不吸烟.年龄较大、文化程度较低或一线生产工人的吸烟率较高,与朋友或吸烟者在一起、在家或休闲时吸烟较常见,63.0%的吸烟者觉得戒烟不难(自评戒烟难度30分以下),目前想过戒烟的占44.4%.吸烟者认为吸烟可引致肺癌和冠心病的比例分别为92.9%和86.1%,认为吸二手烟能引致肺癌和冠心病的比例分别占89.9%和83.3%.自我评价戒烟的难度与尼古丁依赖性明显相关,与自评＜30分比,自评30～60分和＞60分的吸烟者尼古丁依赖性的OR值(95%CI)分别为2.03(0.47～8.68)和9.90(3.09～31.75).结论 男性工人的吸烟率仍然很高,但轻度烟瘾的占大部分,且自评戒烟难度不大,现时是开展并推动工人戒烟的良好时机.     

两家工厂工人吸烟行为与烟瘾的调查

目的 调查工人的吸烟行为和烟瘾及戒烟意向,为开展控烟工作提供科学依据.方法 通过问卷调查,应用横断面调查方法对江苏省2家工厂的336名工人进行调查;烟瘾调查与评价采用国际问卷(Fagerstrom Test for Nicotine Dependence,FIND);吸烟、烟瘾与某些影响因素的相关性分析采用logistic回归分析.结果 男性260人,吸烟率为69.2%,目前吸烟率为64.6%(168人),戒烟者占总吸烟者的6.7%;女性均为从不吸烟.年龄较大、文化程度较低或一线生产工人的吸烟率较高,与朋友或吸烟者在一起、在家或休闲时吸烟较常见,63.0%的吸烟者觉得戒烟不难(自评戒烟难度30分以下),目前想过戒烟的占44.4%.吸烟者认为吸烟可引致肺癌和冠心病的比例分别为92.9%和86.1%,认为吸二手烟能引致肺癌和冠心病的比例分别占89.9%和83.3%.自我评价戒烟的难度与尼古丁依赖性明显相关,与自评＜30分比,自评30～60分和＞60分的吸烟者尼古丁依赖性的OR值(95%CI)分别为2.03(0.47～8.68)和9.90(3.09～31.75).结论 男性工人的吸烟率仍然很高,但轻度烟瘾的占大部分,且自评戒烟难度不大,现时是开展并推动工人戒烟的良好时机.     

心血管疾病家族史和吸烟对缺血性脑卒中发病的联合效应

目的 探讨蒙古族人群心血管疾病家族史和吸烟的联合作用与缺血性脑卒中事件发生的关系。方法 2002-2003年在完成2589名蒙古族研究对象基线调查的基础上,进行10年随访观察,将缺血性脑卒中作为终点事件。按心血管疾病家族史与吸烟状况将2589名研究对象分为无心血管疾病家族史/不吸烟、无心血管疾病家族史/吸烟、心血管疾病家族史/不吸烟、心血管疾病家族史/吸烟四组。以Kaplan-Meier(K-M)方法描述4个组研究对象的缺血性脑卒中累积发病率。应用Cox比例风险模型,估计发生缺血性脑卒中的风险比(HR)及其95%CI。结果 K-M分析结果显示,上述4个组的累积发病率分别为1.17%(15/1278)、3.83%(37/967)、5.70%(9/158)、8.33%(15/180)。经Cox模型分析,在调整年龄、男性、饮酒情况、SBP、DBP、BMI、FPG、TC、TG、LDL-C后,与无心血管疾病家族史/不吸烟组相比,无心血管疾病家族史/吸烟组、有心血管疾病家族史/吸烟组的HR值分别为2.26(95%CI:1.19~4.28)和2.45(95%CI:1.13~5.33),差异均有统计学意义(P<0.05),以心血管疾病家族史/吸烟组发生缺血性脑卒中的危险性最高。结论 具有心血管疾病家族史的吸烟人群可增加缺血性脑卒中的危险性。     

Smoking cessation and mortality from cardiovascular disease among Japanese men and women: the JACC Study

To examine the effect of smoking cessation on cardiovascular disease mortality in Asians, the authors conducted a 10-year prospective cohort study of 94,683 Japanese (41,782 men and 52,901 women) aged 40-79 years who were part of the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). During 941,043 person-years of follow-up between 1989-1990 and 1999, 698 deaths from stroke, 348 from coronary heart disease, and 1,555 from total cardiovascular disease occurred in men and 550, 199, and 1,155, respectively, in women. For men, the multivariate relative risks for current smokers compared with never smokers were 1.39 (95% confidence interval (CI): 1.13, 1.70) for stroke, 2.51 (95% CI: 1.79, 3.51) for coronary heart disease, and 1.60 (95% CI: 1.39, 1.84) for total cardiovascular disease. The respective relative risks for women were 1.65 (95% CI: 1.21, 2.25), 3.35 (95% CI: 2.23, 5.02), and 2.06 (95% CI: 1.69, 2.51), with larger excess risks for persons aged 40-64 years than for older persons. The risk decline after smoking cessation occurred for coronary heart disease and total cardiovascular disease within 2 years and for total stroke after 2-4 years. For each endpoint and in both age subgroups of 40-64 and 65-79 years, most of the benefit of cessation occurred after 10-14 years following cessation. Findings imply the importance of smoking cessation at any age to prevent cardiovascular disease in Japanese.     

Excess mortality among cigarette smokers: changes in a 20-year interval.

OBJECTIVES: This study was undertaken to examine changes in smoking-specific death rates from the 1960s to the 1980s. METHODS: In two prospective studies, one from 1959 to 1965 and the other from 1982 to 1988, death rates from lung cancer, coronary heart disease, and other major smoking-related diseases were measured among more than 200,000 current smokers and 480,000 lifelong non-smokers in each study. RESULTS: From the first to the second study, lung cancer death rates (per 100,000) among current cigarette smokers increased from 26 to 155 in women and from 187 to 341 in men; the increase persisted after current daily cigarette consumption and years of smoking were controlled for. Rates among nonsmokers were stable. In contrast, coronary heart disease and stroke death rates decreased by more than 50% in both smokers and nonsmokers. The all-cause rate difference between smokers and nonsmokers doubled for women but was stable for men. CONCLUSIONS: Premature mortality (the difference in all-cause death rates between smokers and nonsmokers) doubled in women and continued unabated in men from the 1960s to the 1980s. Lung cancer surpassed coronary heart disease as the largest single contributor to smoking-attributable death among White middle-class smokers.     

White blood cell count and incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African-American and White men and women: atherosclerosis risk in communities study

The authors examined the association between white blood cell (WBC) count and incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in 13,555 African-American and White men and women from the Atherosclerosis Risk in Communities (ARIC) Study. Blood was drawn at the ARIC baseline examination, beginning in 1987-1989. During an average of 8 years of follow-up (through December 1996), there were 488 incident coronary heart disease events, 220 incident strokes, and 258 deaths from cardiovascular disease. After adjustment for age, sex, ARIC field center, and multiple risk factors, there was a direct association between WBC count and incidence of coronary heart disease (p < 0.001 for trend) and stroke (p for trend < 0.001) and mortality from cardiovascular disease (p for trend < 0.001) in African Americans. The African Americans in the highest quartile of WBC count (> or =7,000 cells/mm(3)) had 1.9 times the risk of incident coronary heart disease (95% confidence interval (CI): 1.19, 3.09), 1.9 times the risk of incident ischemic stroke (95% CI: 1.03, 3.34), and 2.3 times the risk of cardiovascular disease mortality (95% CI: 1.38, 3.72) as their counterparts in the lowest quartile of WBC count (<4,800 cells/mm(3)). These associations were similar in Whites and in never smokers. An elevated WBC count is directly associated with increased incidence of coronary heart disease and ischemic stroke and mortality from cardiovascular disease in African-American and White men and women.     

Adult height and the risk of cardiovascular disease among middle aged men and women in Japan

An inverse association between height and risk of cardiovascular disease has been reported, but the evidence is limited for stroke subtypes, in particular in Asian populations. Further, few studies have examined how socioeconomic status in adulthood influence the relationship between height and risk of cardiovascular disease. This study examined the association between height and risks of stroke and coronary heart disease, and whether education level, an indicator of adult socioeconomic status, modify the effect of height on those risks, within a cohort of the Japan Public Health Center-based Prospective Study (JPHC Study). The hazard ratios for the incidence of cardiovascular disease associated with height were calculated by a 16-year follow-up of 15,564 Japanese men and women, aged 40–59. The hazard ratios were adjusted for age, gender, area, education, occupation and cardiovascular risk factors. Height was inversely associated with risks of total stroke, either hemorrhagic or ischemic stroke but not with coronary heart disease. The adjusted hazard ratios (95% confidence interval (CI)) of total stroke, hemorrhagic stroke, and ischemic stroke for a 1 SD height increments were 0.82 (95% CI: 0.74, 0.90), 0.80 (95% CI: 0.70, 0.92), and 0.83 (95% CI: 0.73, 0.95), respectively. No multiplicative interaction was observed between height and education level on stroke risk. Short stature was associated with increased risk of total stroke, either hemorrhagic or ischemic stroke, independent of adult socioeconomic status and cardiovascular risk factors, but not with risk of coronary heart disease in Japanese men and women.     

Smoking and causes of death among U.S. veterans: 16 years of observation

In a 16-year mortality followup of some 293,000 insured U.S. veterans, specific causes of death were studied in relation to smoking status. The main results confirmed earlier findings.Mortality ratios for cigarette smokers as compared with nonsmokers were 1.73 for all causes of death, 1.58 for all cardiovascular diseases, 2.12 for all cancers, and 4.31 for all respiratory diseases. The highest ratios (those greater than 5.0) were observed for cor pulmonale, aortic aneurysm, emphysema and bronchitis, cancer of the pharynx, cancer of the esophagus, cancer of the larynx, and cancer of the lung and bronchus. The greatest excess in deaths in terms of observed numbers minus expected was found for the cardiovascular diseases, in particular for coronary heart disease.Mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians'' orders were much lower compared with nonsmokers than the mortality ratios for current cigarette smokers: 1.21 for all causes, 1.15 for all cardiovascular diseases, 1.39 for all cancers, and 2.08 for all respiratory diseases. For most causes of death, the mortality ratios for ex-cigarette smokers who had stopped smoking for reasons other than physicians'' orders varied inversely with the number of years of cessation. For some diseases, the mortality risk for the ex-cigarette smoker returned to normal almost immediately after the cessation of smoking, whereas for others, the return to normal was more gradual. The first group included stroke and the combined category of influenza and pneumonia; the second group included cardiovascular diseases as a whole and coronary heart disease. For still other diseases, although the mortality ratio declined with the length of time smoking was discontinued, substantial excess risks remained even after 20 years of cessation. In this third group were aortic aneurysm, bronchitis and emphysema, and lung cancer—diseases with very high mortality ratios for current cigarette smokers. Parkinson''s disease remained the one disease that clearly exhibited a negative association with cigarette smoking.     

云南省白族居民吸烟和被动吸烟现状及其对脑卒中患病影响

目的了解云南省白族居民吸烟和被动吸烟现状及其对脑卒中患病的影响,为脑卒中的预防控制提供科学依据。方法于2018年4—5月采用多阶段分层随机抽样方法在云南省大理州剑川县抽取2501名≥35岁白族居民进行问卷调查。结果云南省2501名≥35岁白族居民中,现在吸烟者762人,现在吸烟率为30.5%;被动吸烟者528人,被动吸烟率为21.1%;患脑卒中者155例,脑卒中患病率为6.2%。多因素logistic回归分析结果显示,在控制了性别、年龄、文化程度、年人均收入等混杂因素后,现在吸烟白族居民患脑卒中的风险为非现在吸烟白族居民的3.717倍(OR=3.717,95%CI=1.624~2.231),被动吸烟白族居民患脑卒中的风险为非被动吸烟白族居民的3.690倍(OR=3.690,95%CI=2.562~5.394)。结论云南省白族居民现在吸烟率较高,被动吸烟率较低,吸烟和被动吸烟均可增加脑卒中的患病风险。     

Smoking cessation, weight gain, and changes in cardiovascular risk factors during menopause: the Healthy Women Study.

OBJECTIVES: The relationship between smoking cessation, subsequent weight gain, and cardiovascular disease risk factors from premenopause to postmenopause was studied. METHODS: Healthy Women Study participants were assessed for changes in coronary heart disease risk factors from a premenopausal baseline assessment to first- and second-year postmenopausal assessments. RESULTS: Although ex-smokers gained substantially more weight than nonsmokers and smokers, they did not experience a greater increase in cardiovascular risk factors. In fact, the results indicated a trend toward ex-smokers' high-density lipoprotein cholesterol levels increasing slightly more than those of nonsmokers and smokers. CONCLUSIONS: Smoking cessation in perimenopausal to postmenopausal women is associated with greater weight gain but appears to be modestly associated with certain positive changes in cardiovascular risk factors.