Ekberg-Aronsson M, Nilsson P M, Nilsson J-A, Löfdahl C-G, Löfdahl K
Department of Respiratory Medicine and Allergology, Lund University Hospital, University of Lund, Lund, 221 85, Sweden.
Eur J Epidemiol. 2007;22(5):301-9. doi: 10.1007/s10654-007-9120-7. Epub 2007 May 30.
Increased mortality risks associated with smoking are well established among men. There are very few population-based studies comprising a sufficient number of heavily smoking women, measuring the direct effect of smoking on mortality risks. Between 1974 and 1992, 8,499 women and 13,888 men attended a health screening programme including reporting of smoking habits. Individuals were followed for total mortality until 2005. All-cause, cancer, cardiovascular, lung cancer and respiratory mortality were calculated in smoking categories <10 g per day, 10-19 g per day, and > or =20 g per day with never-smokers as a reference group and with adjustments for co-morbidities, socio-economic and marital status. For respiratory mortality and lung cancer adjustments for FEV(1), socio-economic and marital status were performed. Smoking was associated with a two to almost threefold increased mortality risk among women and men. The relative risk (RR) with 95% confidence interval, (CI) for women who smoked 10-19 g per day was 2.44 (2.07-2.87), and for those who smoked 20 g per day or more the RR (95% CI) was 2.42 (2.00-2.92). Smoking was a strong risk factor for cardiovascular mortality among women, the RR (95% CI) for women who smoked 10-19 g per day was 4.52 (3.07-6.64). Ex-smoking women showed increased risks of all-cause mortality; RR (95% CI) 1.26 (1.04-1.52) cancer (excluding lung cancer); RR (95% CI) 1.42 (1.07-1.88) and lung cancer RR (95% CI) 2.71 (1.02-7.23) mortality. However, the cardiovascular; RR (95% CI) 1.18 (0.69-2.00) and respiratory; RR (95% CI) 0.79 (0.16-3.84) mortality risks were not statistically significant. This study confirms that as for men, middle-aged heavily smoking women have a two to threefold increased mortality risk. Adjustments for co-morbidity, socio-economic and marital status did not change these results.
吸烟与男性死亡率增加之间的关联已得到充分证实。基于人群的研究中，很少有包含足够数量重度吸烟女性的研究来衡量吸烟对死亡率的直接影响。1974年至1992年期间，8499名女性和13888名男性参加了一项健康筛查计划，其中包括报告吸烟习惯。对个体进行随访直至2005年，统计全因死亡率、癌症死亡率、心血管疾病死亡率、肺癌死亡率和呼吸系统疾病死亡率。以从不吸烟者为参照组，按照每日吸烟量<10克、10 - 19克、≥20克进行分类计算，并对合并症、社会经济状况和婚姻状况进行调整。对于呼吸系统疾病死亡率和肺癌死亡率，还对第一秒用力呼气量（FEV₁）、社会经济状况和婚姻状况进行了调整。吸烟与女性和男性死亡率增加两倍至近三倍相关。每日吸烟10 - 19克女性的相对风险（RR）及95%置信区间（CI）为2.44（2.07 - 2.87），每日吸烟20克及以上女性的RR（95% CI）为2.42（2.00 - 2.92）。吸烟是女性心血管疾病死亡率的一个强风险因素，每日吸烟10 - 19克女性的RR（95% CI）为4.52（3.07 - 6.64）。已戒烟女性的全因死亡率风险增加；RR（95% CI）为1.26（1.04 - 1.52），癌症（不包括肺癌）死亡率；RR（95% CI）为1.42（1.07 - 1.88），肺癌死亡率RR（95% CI）为2.71（1.02 - 7.23）。然而，心血管疾病死亡率；RR（95% CI）为1.18（0.69 - 2.00）和呼吸系统疾病死亡率；RR（95% CI）为0.79（0.16 - 3.84）无统计学意义。这项研究证实，与男性一样，中年重度吸烟女性的死亡率风险增加两倍至三倍。对合并症、社会经济状况和婚姻状况进行调整后，这些结果并未改变。
