Quantifying the association of low-intensity and late initiation of tobacco smoking with total and cause-specific mortality in Asia
- Authors
- Yang, J.J.[Yang, J.J.]; Yu, D.[Yu, D.]; Shu, X.-O.[Shu, X.-O.]; Freedman, N.D.[Freedman, N.D.]; Wen, W.[Wen, W.]; Rahman, S.[Rahman, S.]; Abe, S.K.[Abe, S.K.]; Saito, E.[Saito, E.]; Gupta, P.C.[Gupta, P.C.]; He, J.[He, J.]; Tsugane, S.[Tsugane, S.]; Gao, Y.-T.[Gao, Y.-T.]; Xiang, Y.-B.[Xiang, Y.-B.]; Yuan, J.-M.[Yuan, J.-M.]; Tomata, Y.[Tomata, Y.]; Tsuji, I.[Tsuji, I.]; Sugawara, Y.[Sugawara, Y.]; Matsuo, K.[Matsuo, K.]; Ahn, Y.-O.[Ahn, Y.-O.]; Park, S.K.[Park, S.K.]; Chen, Y.[Chen, Y.]; Pan, W.-H.[Pan, W.-H.]; Pednekar, M.[Pednekar, M.]; Gu, D.[Gu, D.]; Sawada, N.[Sawada, N.]; Cai, H.[Cai, H.]; Li, H.-L.[Li, H.-L.]; Koh, W.-P.[Koh, W.-P.]; Wang, R.[Wang, R.]; Zhang, S.[Zhang, S.]; Kanemura, S.[Kanemura, S.]; Ito, H.[Ito, H.]; Shin, M.-H.[Shin, M.-H.]; Wu, P.-E.[Wu, P.-E.]; Yoo, K.-Y.[Yoo, K.-Y.]; Ahsan, H.[Ahsan, H.]; Chia, K.S.[Chia, K.S.]; Boffetta, P.[Boffetta, P.]; Inoue, M.[Inoue, M.]; Kang, D.[Kang, D.]; Potter, J.D.[Potter, J.D.]; Zheng, W.[Zheng, W.]
- Issue Date
- May-2021
- Publisher
- BMJ PUBLISHING GROUP
- Keywords
- smoking caused disease; prevention; socioeconomic status
- Citation
- TOBACCO CONTROL, v.30, no.3, pp.328 - 335
- Indexed
- SCIE
SSCI
SCOPUS
- Journal Title
- TOBACCO CONTROL
- Volume
- 30
- Number
- 3
- Start Page
- 328
- End Page
- 335
- URI
- https://scholarworks.bwise.kr/skku/handle/2021.sw.skku/2277
- DOI
- 10.1136/tobaccocontrol-2019-055412
- ISSN
- 0964-4563
- Abstract
- Background Little is known about the health harms associated with low-intensity smoking in Asians who, on average, smoke fewer cigarettes and start smoking at a later age than their Western counterparts. Methods In this pooled analysis of 738 013 Asians from 16 prospective cohorts, we quantified the associations of low-intensity (<5 cigarettes/day) and late initiation (>= 35 years) of smoking with mortality outcomes. HRs and 95% CIs were estimated for each cohort by Cox regression. Cohort-specific HRs were pooled using random-effects meta-analysis. Findings During a mean follow-up of 11.3 years, 92 068 deaths were ascertained. Compared with never smokers, current smokers who consumed <5 cigarettes/day or started smoking after age 35 years had a 16%-41% increased risk of all-cause, cardiovascular disease (CVD), respiratory disease mortality and a >twofold risk of lung cancer mortality. Furthermore, current smokers who started smoking after age 35 and smoked <5 cigarettes/day had significantly elevated risks of all-cause (HRs (95% CIs)=1.14 (1.05 to 1.23)), CVD (1.27 (1.08 to 1.49)) and respiratory disease (1.54 (1.17 to 2.01)) mortality. Even smokers who smoked <5 cigarettes/day but quit smoking before the age of 45 years had a 16% elevated risk of all-cause mortality; however, the risk declined further with increasing duration of abstinence. Conclusions Our study showed that smokers who smoked a small number of cigarettes or started smoking later in life also experienced significantly elevated all-cause and major cause-specific mortality but benefited from cessation. There is no safe way to smoke-not smoking is always the best choice.
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Collections - Medicine > Department of Medicine > 1. Journal Articles
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