Joint association of adiposity and smoking with mortality among U.S. adults |
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| Authors: | Jiemin Ma Ahmedin Jemal W Dana Flanders Elizabeth M Ward |
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| Institution: | 1. Department of Intramural Research, American Cancer Society, Atlanta, GA, USA;2. Departments of Epidemiology and Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA;1. Laboratoire Microorganismes et Biomolécules Actives (LMBA), Department of Biology, Faculty of Sciences, El Manar University, Tunis, Tunisia;2. INSERM U1176, Kremlin-Bicêtre Hospital, Bicêtre, France;3. L99ES11 Research Laboratory Department of Biochemistry, Rabta Hospital, El Manar University, Tunis, Tunisia;1. Liver and Hepatobiliary Unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;2. Centre for Liver Research, University of Birmingham, Birmingham, UK;3. National Institute for Alcoholism and Alcohol Abuse, National Institutes of Health, Rockville, MD, USA;4. Mount Sinai Medical Centre, New York, NY, USA;5. Imperial College Healthcare NHS Foundation Trust, UK;6. Department of Liver Medicine, University Hospitals Bristol NHS Foundation Trust, UK;7. NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University Of Nottingham, Nottingham, UK |
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| Abstract: | ObjectiveAssessment of death risk for different combinations of body-mass index (BMI) and smoking status among a nationally representative cohort of U.S. adults.MethodA total of 210,818 participants of the National Health Interview Surveys 1987–1995 were followed through 2006. Relative risks of death from all causes, cardiovascular disease (CVD), and cancer were estimated for each joint group of smoking and BMI by age, using Cox models with the adjustment for age, gender, education, and race.ResultsAcross all the joint groups of BMI and smoking, extremely obese and underweight current smokers were the two groups having the highest risks of death from all causes, CVD, and cancer. For example, among middle-aged adults, the hazard ratios of death from all causes were 4.47 (95% confidence interval CI], 3.59–5.57) and 5.28 (4.38–6.37) for extremely obese and underweight current smokers, respectively. Overweight was associated with a higher risk of death in middle-aged never smokers, but not in the elderly or in current smokers.ConclusionThe coexistence of obesity or underweight with current smoking was associated with an especially large risk of death and the associations of BMI with mortality varied by smoking status, age, and cause of death. |
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