Pelkonen M, Tukiainen H, Tervahauta M, Notkola I L, Kivelä S L, Salorinne Y, Nissinen A
University of Kuopio, Department of Public Health and General Practice, Kuopio, Finland.
Thorax. 2000 Sep;55(9):746-50. doi: 10.1136/thorax.55.9.746.
Although it is well known that impaired pulmonary function is a strong predictor of mortality and that smoking decreases pulmonary function, little is known about the long term effect of smoking cessation on mortality at different levels of pulmonary function. We have studied the impact of smoking cessation on mortality over the entire range of baseline pulmonary function.
The study subjects consisted of men aged 40-59 at entry who were the Finnish participants in the Seven Countries Study during 1959-89.
In all the participants (n = 1582) impaired forced expiratory volume in 0.75 seconds (FEV(0.75)) was significantly associated with increased all cause mortality. When those who gave up smoking during the follow up period were compared with continuous smokers (n = 860) all cause mortality was found to be decreased among those who quit. The relative adjusted hazard (HR) was 0.71 (95% confidence interval 0.50 to 1.00). The median survival time in those who stopped smoking compared with those who continued to smoke from 1969 onwards was 7.65, 7.59, and 6.30 years longer in the lowest, middle and highest tertiles of adjusted FEV(0.75) distribution, respectively. In those who gave up smoking, mortality from cardiovascular causes was significantly lower (HR 0.60 (95% CI 0.37 to 0.98)).
These findings suggest that smokers across the entire range of pulmonary function may increase their expectation of lifespan by giving up smoking.
虽然众所周知，肺功能受损是死亡率的一个强有力的预测指标，且吸烟会降低肺功能，但对于在不同肺功能水平下戒烟对死亡率的长期影响知之甚少。我们研究了在整个基线肺功能范围内戒烟对死亡率的影响。
研究对象包括1959 - 1989年期间参与七国研究的芬兰40 - 59岁男性。
在所有参与者（n = 1582）中，0.75秒用力呼气量（FEV(0.75)）受损与全因死亡率增加显著相关。当将随访期间戒烟者与持续吸烟者（n = 860）进行比较时，发现戒烟者的全因死亡率有所降低。相对调整后的风险比（HR）为0.71（95%置信区间0.50至1.00）。从1969年起，在调整后的FEV(0.75)分布的最低、中间和最高三分位数中，戒烟者与继续吸烟者相比，中位生存时间分别长7.65年、7.59年和6.30年。在戒烟者中，心血管原因导致的死亡率显著更低（HR 0.60（95%CI 0.37至0.98））。
这些发现表明，整个肺功能范围内的吸烟者都可以通过戒烟来提高其预期寿命。
