West R R
University of Wales College of Medicine, Cardiff.
J R Coll Physicians Lond. 1992 Oct;26(4):357-66.
Smoking is strongly associated with age-specific death rates for a number of diseases. Increased age-specific death rates for a disease may imply either more deaths from the disease with increased absolute lifetime risk, or earlier deaths, without increased absolute lifetime risk. The British doctor smoking data are re-analysed using lifetable methods for survival, cumulative mortality and the disease-specific cumulative mortality. The most significant effect of smoking is on survival: life shortening amounts to three years for light smokers, five for moderate smokers, and eight for heavy smokers, compared with those who never smoked. Smoking increases the absolute number of deaths from some causes, including lung cancer; for other causes, including ischaemic heart disease, it brings forward death without increasing the absolute number of deaths. The smoking associations with more or earlier death have implications for research into the mechanisms of disease causation, for health promotion, for rational health-care planning, and for social policy.
吸烟与多种疾病的年龄别死亡率密切相关。一种疾病的年龄别死亡率上升，可能意味着随着绝对终生风险增加，该疾病导致的死亡人数增多，或者意味着死亡时间提前，而绝对终生风险并未增加。利用生命表方法对英国医生吸烟数据进行重新分析，以研究生存情况、累积死亡率和疾病特异性累积死亡率。吸烟最显著的影响是对生存的影响：与从不吸烟的人相比，轻度吸烟者的寿命缩短三年，中度吸烟者缩短五年，重度吸烟者缩短八年。吸烟会增加包括肺癌在内的某些病因导致的死亡绝对数；而对于包括缺血性心脏病在内的其他病因，吸烟会使死亡时间提前，但不会增加死亡绝对数。吸烟与更多或更早死亡之间的关联，对疾病病因机制研究、健康促进、合理的医疗保健规划以及社会政策都有影响。
