Enstrom J E, Heath C W
School of Public Health and Jonsson Comprehensive Cancer Center, University of California, Los Angeles 90095-1772, USA.
Epidemiology. 1999 Sep;10(5):500-12.
We assessed the impact of smoking cessation on subsequent death rates among a cohort of 51,343 men and 66,751 women in California enrolled in late 1959 in the original American Cancer Society (ACS) Cancer Prevention Study (CPS I) and followed for 38 years. We compared the age-adjusted death rate, expressed as deaths per 1,000 person-years, among all subjects who smoked cigarettes in 1959 but who had largely quit as of 1997 with the death rate among never smokers over a 38-year period. The all causes death rate for males decreased from 20.67 during 1960-1969 to 18.68 during 1960-1997 for smokers and decreased from 10.51 to 9.46 for never smokers. The lung cancer death rate for males increased from 1.558 to 1.728 for smokers and increased from 0.127 to 0.133 for never smokers. The all causes death rate for females increased from 9.54 to 10.14 for smokers and decreased from 6.95 to 6.44 for never smokers. The lung cancer death rate for females increased greatly from 0.208 to 0.806 for smokers and increased from 0.094 to 0.116 for never smokers. These results indicate there has been no important decline in either the absolute or relative death rates from all causes and lung cancer for cigarette smokers as a whole compared with never smokers in this large cohort, in spite of a substantial degree of smoking cessation. While cessation clearly reduces the mortality risk among long-term former smokers, the population impact of cessation appears to be less than currently believed.
我们评估了戒烟对加利福尼亚州51343名男性和66751名女性后续死亡率的影响。这些人于1959年末参加了美国癌症协会（ACS）最初的癌症预防研究（CPS I），并随访了38年。我们将1959年吸烟但到1997年已基本戒烟的所有受试者的年龄调整死亡率（以每1000人年的死亡人数表示）与从不吸烟者在38年期间的死亡率进行了比较。吸烟者的全因死亡率从1960 - 1969年的20.67降至1960 - 1997年的18.68，从不吸烟者的全因死亡率从10.51降至9.46。男性吸烟者的肺癌死亡率从1.558升至1.728，从不吸烟者从0.127升至0.133。女性吸烟者的全因死亡率从9.54升至10.14，从不吸烟者从6.95降至6.44。女性吸烟者的肺癌死亡率从0.208大幅升至0.806，从不吸烟者从0.094升至0.116。这些结果表明，在这个大型队列中，与从不吸烟者相比，整体而言，吸烟者的全因死亡率和肺癌死亡率在绝对或相对水平上均未出现显著下降，尽管戒烟程度相当大。虽然戒烟显然降低了长期既往吸烟者的死亡风险，但戒烟对总体人群的影响似乎小于目前的认知。
