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...     

老年人吸烟及戒烟与相关死亡的前瞻性研究

目的：前瞻性探讨男性老年人吸烟及戒烟与烟草有关疾病死亡的相互关系。方法：研究对象为1987年西安市22个军队干休所的全部男性离体干部,共计1268人,基线调查时,388人为不吸烟者,419人为吸烟者,461人为戒烟者。终点指标为全死因和与烟草有关疾病死亡。结果：截止1999年,共观察14163人年,平均随访11年。共死亡299人,943人存活,26人失访。在调整了年龄,血压、体重指数,总胆固醇,甘油三酯、饮酒,体育锻炼和既往病史等因素后,多元Cox生存分析模型显示：既往吸烟与该人群相关死亡的对危险度（95％CI）分别为总死亡1．34（1．02－1．76）、慢性阻塞性肺病（COPD）3．23（0．95－10．91）,肺癌、2．31（0．95－5．61）、冠心病1．60（0．81－3．19）。其死亡危险性随既吸烟量的增多和吸烟年限的延长而升高,存在明确的剂量反应关系。与继续吸烟者相比,戒烟总死亡和冠心病死亡和危险性分别下降56％和93％,但COPD的死亡危险却升高了174％。结论：（1）吸烟是中国男性老年人的主要死因之一,而戒烟降低总死亡和心血管病死亡;（2）戒烟者COPD死亡危险高于继续吸烟者的原因可能与“无病吸烟者作用”和“因病戒烟作用有关。     

吸烟、被动吸烟与肺癌发病风险的病例对照研究

目的 探讨吸烟、被动吸烟与肺癌的关联.方法 采用病例对照研究设计,面访肺癌新发病例1 303例和按性别、年龄(±2岁)频数匹配的健康对照1 303例.结果 吸烟是男性肺癌的重要危险因素(调整OR=4.974,95％ CI:3.933 ～6.291),随着开始吸烟年龄提前、吸烟年限延长、日吸烟量、吸烟包年以及吸烟深度的增加,患肺癌危险性增高,呈剂量反应关系(Ptrend＜0.001),戒烟≥10年患肺癌的危险性降低45.4％.男性吸烟患肺鳞癌的危险性比患肺腺癌大.被动吸烟是非吸烟者肺癌的危险因素(调整OR=1.912,95％CI:1.486～2.460),工作环境被动吸烟的男性非吸烟者患肺癌的调整OR为2.221(95％CI:1.361 ～3.625),家庭环境被动吸烟的女性非吸烟者患肺癌的调整OR为1.804(95％ CI:1.270～2.562).68.04％男性肺癌的发生可归因于吸烟,26.51％非吸烟者肺癌的发生可归因于被动吸烟.结论 吸烟是肺癌的重要危险因素,工作环境被动吸烟是男性非吸烟者肺癌的主要危险因素,家庭环境被动吸烟是女性肺癌的主要危险因素.戒烟具有重大的公共卫生学意义.     

不同胆固醇水平人群吸烟与冠心病死亡的关系

目的探讨在不同胆固醇水平人群中吸烟与冠心病死亡的关系。方法采用Cox模型前瞻性分析西安某工厂1976年健康检查的1696名职工(男性1124,女性572)中血清总胆固醇和甘油三酯、吸烟等因素与冠心病死亡的关系。随访的终点时间为2003年1月31日。结果该队列冠心病死亡人数为59人(男性45、女性14),占总死亡人数的15.6%,总随访人.a为41827。在调整年龄、性别、婚姻状况、教育程度、职业、收缩压及甘油三酯水平后,在正常胆固醇水平组(TC<5.20mmol/L)吸烟致冠心病的死亡风险RR为2.04(95%CI:1.01～4.48),而在高胆固醇血症组(TC≥5.20mmol/L)的RR为2.36(95%CI:1.00～6.05)。分层分析显示,在胆固醇水平<4.24mmol/L、4.24～4.88mmol/L、≥4.89mmol/L组中,调整RR分别为1.97(95%CI:0.62～6.25),2.02(95%CI:0.66～6.17),2.54(95%CI:1.02～6.29),且发现吸烟与胆固醇水平可能存在某种协同作用,在高胆固醇水平组中吸烟者的冠心病死亡风险升高。结论无论人群中总胆固醇水平高低,吸烟均为冠心病的独立危险因素。     

军队男性老年人脑卒中发病与死亡因素的队列研究

目的了解军队男性老年人群脑卒中发病与死亡相关因素。方法从2005年6月30日至2006年6月30日对1987年建立的西安市22所军队干休所离退休干部队列人群进行了再次调查,统计学方法主要应用多元Cox比例风险模型进行多因素分析,由SPSS13.0软件完成。结果至2005年6月30日脑卒中发病186人,调整发病率为984.43/10万人年,其中新发脑梗死157人,新发脑出血29人;至2006年6月30日脑卒中死亡69人,死亡率为357.02/10万人年,其中脑梗死死亡26人,脑出血死亡43人;队列研究结果显示,年龄、收缩压、舒张压、既往脑动脉硬化和高血压病史与脑卒中发病相关,HR值(95%CI)分别为1.037(1.002～1.072)、1.087(1.012～1.169)、1.186(1.050～1.340)、1.515(1.006～2.281)和1.571(1.052～2.347);脑卒中死亡相关因素为年龄、收缩压、吸烟、高血压家族史、卒中家族史、体质指数、卒中、高脂血症和高血压既往病史,HR值(95%CI)分别为1.072(1.017～1.131)、4.283(1.706～10.753)、2.180(1.019～4.665)、2.069(1.066～4.014)、2.069(1.066～4.014)、0.858(0.779～0.946)、10.034(3.366～29.912)、3.351(1.194～9.406)和2.366(1.247～4.491)。结论西安地区军队男性老年人群脑卒中发病以缺血性为主,脑卒中死亡以出血性为主;发病率和死亡率均低于全国水平;控制血压、总胆固醇、总胆红素和体重水平,戒烟,控酒,预防脑动脉硬化、高脂血症和高血压可以降低该人群脑卒中发病风险。     

2018年中国15岁及以上现在吸烟者戒烟意愿及尝试戒烟行为研究

目的描述我国≥15岁现在吸烟者戒烟意愿及尝试戒烟行为, 探讨影响其戒烟行为的主要因素。方法研究对象为我国≥15岁现在吸烟者。采用多阶段分层整群随机抽样, 在全国31个省(自治区、直辖市)共抽取200个监测点, 最终完成调查19 376人。数据加权后, 使用SAS 9.4软件复杂抽样设计方法进行分析, 采用频数和加权构成比进行描述, 使用Rao-Scottχ2检验和非条件多因素logistic回归进行影响因素分析。结果 6.63%的现在吸烟者准备在1个月内戒烟, 男性为5.44%, 女性为8.49%。17.96%的现在吸烟者在过去12个月尝试过戒烟, 男性为17.80%, 女性为22.15%。多因素分析结果显示, 偶尔吸烟(OR=3.42, 95%CI:2.09～5.59)、尝试过戒烟(OR=4.91, 95%CI:0.33～0.52)以及知晓吸烟导致3种疾病(OR=2.24, 95%CI:1.48～3.40), 戒烟意愿较高。偶尔吸烟(OR=1.68, 95%CI:1.20～2.34)、接受过医务人员的戒烟建议(OR=1.96, 95%CI:1.62～2.37)、知晓吸烟导致3种疾病(...     

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.     

西安市军队老年人慢性阻塞性肺疾病死亡危险因素的18年队列研究

目的探讨西安市军队男性老年人慢性阻塞性肺病（COPD）死亡危险因素及相互关系。方法研究对象为1987年西安市22个军队下休所的全部男性离休干部，共计1268人。终点指标为全死因和COPD死亡。结果截止2005年6月30日，共观察18766．28人年，平均随访14．35年；死亡491例，748人存活，29人失访。死亡总例数中COPD居第二位，占16．90％；COPD单因素分析：年龄的RR值95％CI为[1．13（1．09～1．17）]、每日吸烟晕[1．04（1．02～1．06）]、吸烟年限[1．03（1．01～1．04）]、负性生活事件[1．81（2．85～6．77）]、既往COPD史[4．39（285～677）]为COPD死亡危险因素；多因素分析结果显示：年龄的RR值95％CI为[1．10（1．06～1．15）]、每日吸烟量[1．03（1．01～1．06）]、既往COPD史[3．07（1．90～4．98）]为COPD死亡危险因素；其死亡危险性随既往吸烟量的增多和吸烟年限的延长而升高，存在明确的剂量反应关系；戒烟者总死亡的危险下降了66．67％。结论队列中COPD死亡居第二位；年龄、每日吸烟量和既往COPD史是COPD死亡的危险因素；戒烟对COPD死亡的影响有待进一步观察。     

Smoking,quitting, and mortality in a Chinese cohort of retired men

PURPOSE: To examine the relationship between smoking, quitting, and mortality in older Chinese men. DESIGN AND METHODS: A cohort analytic study was carried out in Xi'an, China. A total of 1268 retired male military cadres aged 60 or older were examined in 1987 and followed for 12 years. RESULTS: At baseline, 388 men were never-smokers, 461 were former smokers, and 419 were current smokers. Through May 1999, a total of 299 had died. The relative risks [95% confidence intervals (CI)] for ever-smoking, after adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol drinking, exercise and existing diseases, for deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer, and coronary heart disease (CHD) were, respectively, 1.34 (1.02-1.76), 3.23 (0.95-10.91), 2.31 (0.95-5.61), and 1.60 (0.81-3.19). The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death, but had higher risks for COPD death. CONCLUSIONS: Smoking is a major cause of death in older Chinese and quitting can save lives. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized in the control of the growing tobacco epidemic.     

Smoking and All-Cause Mortality among a Cohort of Urban Transit Operators

This study assesses the contribution of smoking to all-cause mortality among a primarily minority cohort of urban transit operators. Survey and medical exam data, obtained from 1,785 workers (61% African American; 9% female) who participated in the 1983-1985 San Francisco MUNI Health and Safety Study, were matched against state and national death records through 2000. At baseline, approximately 45% of the workers were current smokers, 30% were former smokers, and 25% had never smoked. Covariates were demographic factors (gender, age, race/ethnicity) and alcohol use (average number of drinks per week). There were 198 deaths during the follow-up period. Kaplan-Meier survival analysis indicated that the probability of survival did not differ between former and current smokers, but was significantly lower compared to never smokers (p < 0.001). Data were further analyzed using Cox regression with age, gender, race/ethnicity, years of smoking, and average weekly number of drinks as predictors of mortality. The results showed that years of smoking significantly contributed to mortality (hazard ratio [HR] = 1.023; p < 0.001). Compared to Asian-American transit operators, elevated mortality risk was observed for African-American operators (HR = 2.78, p < 0.01) and white operators (HR = 2.93, p < 0.01). Gender and average weekly number of drinks were not significantly associated with mortality. Although rates of smoking have declined over the past two decades among blue-collar workers, elevated prevalence of former smoking will likely contribute to excess mortality among blue-collar populations.     

The mortality risk of smoking and obesity combined

BACKGROUND: Both smoking and obesity have been linked to increased mortality, but evaluating the joint effect has been limited. This nationwide, prospective mortality study of U.S. radiologic technologists was designed to evaluate the combined mortality risks of obesity and smoking. METHODS: Mortality risk was investigated in 64,120 women and 18,760 men who completed a baseline questionnaire (1983 to 1989). Body mass index (BMI) (weight adjusted for height, or kilograms divided by meters squared) was calculated from self-reported weight and height at baseline, with five categories: less than 18.5 (underweight), 18.5 to 24.9 (normal), 25.0 to 29.9 (overweight), 30.0 to 34.9 (moderately obese), and 35.0 and higher (very obese). Participants were followed from the questionnaire until the date of death or through 2002, whichever occurred first. The combined association among BMI and smoking and all-cause, cancer, and circulatory disease mortality by gender and attained age (less than 65 years, 65 years and older) was examined using Cox proportional hazards regression analyses (conducted in 2005). Person-years at risk averaged 16 years (women aged less than 65), 6 years (women aged 65 and older), 15 years (men aged less than 65), and 7 years (men aged 65 and older), totaling 1.35 million person-years. RESULTS: In all gender/age groups, both obesity and smoking, particularly current smoking, contributed substantially to all-cause mortality, with 3.5- to 5-fold risks for very obese, current smokers compared to normal weight, never smokers. Current smoking was the predominant risk factor for cancer mortality. Combining obesity with current smoking increased circulatory disease mortality by 6- to 11-fold for people aged less than 65 years, compared to normal weight, never smokers. Obese former smokers (less than 65 years) had notably lower risks. CONCLUSIONS: Obese smokers (aged less than 65 years) had strikingly high mortality risks, particularly from circulatory disease mortality.     

上海市区男性吸烟与恶性肿瘤死亡的前瞻性研究

目的 探讨上海市区中老年男性吸烟与恶性肿瘤死亡关系,以及随访期间研究对象吸烟情况的改变对这种关系的影响。方法 自1986年1月至1989年9月调查上海市区45～64岁男性居民18244人,每年上门随访一次;用Cox比例风险模型计算相对危险度(RR)。结果 至2002年度随访结束,全队列共随访235762人年,人均随访12.9年。在此期间共死亡3365例,其中恶性肿瘤死亡1381例。基线调查时吸烟者相对于不吸烟者总死亡RR值为1.49,去除随访期间吸烟情况有变化的对象后,一直吸烟者相对于一直不吸烟者的总死亡RR值增至1.78;相应的恶性肿瘤死亡RR值由2.05增至2.58,肺癌死亡RR值由6.40增至8.77。基线调查时吸烟者年龄标化总死亡率及标化恶性肿瘤死亡率为1695.6/10万人年和782.0/10万人年,去除随访期间吸烟情况有变化的对象后,一直吸烟者相应的标化死亡率增至2353.7/10万人年和1144.6/10万人年。结论 吸烟是上海市区中老年男性总死亡及恶性肿瘤死亡的重要危险因素。不考虑随访期间研究对象吸烟状况的改变会低估吸烟对健康的危害性。     

Joint effect of cigarette smoking and alcohol consumption on mortality

OBJECTIVE: To evaluate the joint effect of cigarette smoking and alcohol consumption on mortality. METHODS: A population-based cohort of 66,743 Chinese men aged 30-89 in Shanghai, China recruited from 1996 to 2000. Lifestyle data were collected using structured questionnaires. As of November 2004, follow-up for the vital status of 64,515 men was completed and death information was further confirmed through record linkage with the Shanghai Vital Statistics Registry. Associations were evaluated by Cox regression analyses. RESULTS: 2514 deaths (982 from cancers, 776 from cardiovascular diseases (CVD)) were identified during 297,396 person-years of follow-up. Compared to never-smokers, both former and current smokers had significantly elevated mortality from any cause, CVD, and cancer; risk increased with amount of smoking. Intake of 1-7 drinks/week was associated with reduced risk of death, particularly CVD death (hazard ratio (HR): 0.7, 95% confidence interval (CI): 0.5, 1.0), whereas intake of >42 drinks/week was related to increased mortality, particularly cancer-related death (HR: 1.7, 95% CI: 1.1, 2.5). The HR for total mortality associated with moderate alcohol consumption increased from 0.8 (95% CI: 0.6, 1.0) for non-smokers to 1.0 (0.9, 1.2) for moderate smokers and 1.4 (95% CI: 1.2, 1.7) for heavy smokers. Heavy drinkers and heavy smokers had the highest mortality (HR: 1.9, 95% CI: 1.6, 2.4). CONCLUSIONS: Light and moderate alcohol consumption reduced mortality from CVD. This beneficial effect, however, was offset by cigarette smoking.     

Estimation of mortality rates for disease simulation models using Bayesian evidence synthesis.

PURPOSE: The authors propose a Bayesian approach for estimating competing risks for inputs to disease simulation models. This approach is suggested when modeling a disease that causes a large proportion of all-cause mortality, particularly when mortality from the disease of interest and other-cause mortality are both affected by the same risk factor. METHODS: The authors demonstrate a Bayesian evidence synthesis by estimating other-cause mortality, stratified by smoking status, for use in a simulation model of lung cancer. National (US) survey data linked to death registries (National Health Interview Survey [NHIS]--Multiple Cause of Death files) were used to fit cause-specific hazard models for 3 causes of death (lung cancer, heart disease, and all other causes), controlling for age, sex, race, and smoking status. Synthesis of NHIS data with national vital statistics data on numbers and causes of deaths was performed in WinBUGS (version 1.4.1, MRC Biostatistics Unit, UK). Correction for inconsistencies between the NHIS and vital statistics data is described. A published cohort study was a source of prior information for smoking-related mortality. RESULTS: Marginal posterior densities of annual mortality rates for lung cancer and other-cause death (further divided into heart disease and all other causes), stratified by 5-year age interval, race (white and black), gender, and smoking status (current, former, never), were estimated, specific to a time period (1987-1995). Overall, black current smokers experienced the highest mortality rates. CONCLUSIONS: Bayesian evidence synthesis is an effective method for estimation of cause-specific mortality rates, stratified by demographic factors.     

Mortality attributable to cigarette smoking in a cohort study in Japan

We conducted this study to estimate the association and population attributable risk (PAR) of smoking with all-cause and cause-specific mortality based on a general prospective cohort study in Japan. A total of 8,129 subjects (3,996 males and 4,133 females) aged 40 or over were analyzed. The follow-up period was from 1986 to 2003. Smoking habit was classified into three categories of never smoker, former smoker, and current smoker. The Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). We also estimated the PAR of smoking, and calculated the 95% CI of PAR based on the bootstrap procedure. A total of 112,151 person-years were counted for 8,129 subjects over an average of 13.7 years of follow-up. The results showed that smoking increased the risk of dying from all cancers, cardiovascular, and respiratory diseases in both sexes. For all causes of death, smokers had a HR of 1.30 (95% CI: 1.09, 1.54), PAR of 13.1% (95% CI: 7.6, 22.3) in males, and HR of 1.81 (95% CI: 1.43, 2.29), and PAR of 6.1% (95% CI: 3.1, 9.3) in females compared to never smokers. These results confirm an increased risk of mortality from all causes, as well as from all cancers, cardiovascular disease, and respiratory disease in relation to smoking habit. Smoking is responsible for a considerable proportion of deaths due to all causes as well as cause-specific deaths. Population-based antismoking programs should be implemented to reduce such avoidable deaths.     

Smoking and risk of all-cause mortality: the Jichi Medical School (JMS) Cohort Study

BACKGROUND: There have been comparatively few large-scale cohort studies analyzing all-cause mortality due to cigarette smoking. The goal of this analysis is to investigate the relationship between smoking status and all-cause mortality, and to evaluate the effect of smoking in the Japanese. METHODS: The baseline data were collected between 1992 and 1995. Ultimately, 10,873 Japanese (4,280 males and 6,593 females) aged 19 years or older from 12 rural communities located across Japan participated in the study. This analysis is based on the results, including the information on those who died and moved out of the communities, obtained by December 31, 2001. The Cox's proportional hazards model was used to calculate the hazard ratio (HR) of mortality for smoking with adjustment for age, systolic blood pressure, total cholesterol, body mass index, alcohol drinking habit and education. RESULTS: The mean follow-up period was 8.2 years, during which time, 284 males and 192 females died. The multivariate-adjusted HRs for total mortality among former and current smokers compared with never smokers were 1.09 (95% confidence interval [CI]: 0.73-1.61) and 1.65 (95% CI: 1.16-2.35) in males, and 0.98 (95% CI: 0.40-2.42) and 0.91 (95% CI: 0.42-1.95) in females, respectively. Those for the consumption of 1-14, 15-24, and 25+ cigarettes per day among male smokers were 1.62, 1.57, and 1.89, respectively. In females, there was no great difference in all-cause mortality between smokers and never smokers. CONCLUSIONS: The results of our study confirm an increased risk in males of premature death from all causes among Japanese with a smoking habit.