Kuller L H, Ockene J K, Meilahn E, Wentworth D N, Svendsen K H, Neaton J D
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15261.
Prev Med. 1991 Sep;20(5):638-54. doi: 10.1016/0091-7435(91)90060-h.
The relationship of cigarette smoking and smoking cessation to mortality was investigated among men screened for and also among those randomized to the Multiple Risk Factor Intervention Trial (MRFIT).
Among the 361,662 men screened for the MRFIT, cigarette smoking was an important risk factor for all-cause, coronary heart disease (CHD), stroke, and cancer mortality. These risks, on the log relative scale, were strongest for cancers of the lung, mouth, and larynx. The excess risk associated with cigarette smoking was greatest for death from CHD. Overall, approximately one-half of all deaths were associated with cigarette smoking. Among the 12,866 randomized participants, weak positive associations with duration of cigarette smoking habit and tar and nicotine levels were found with all-cause mortality. For both SI and UC men, substantial differences in subsequent CHD (34-49%) and all-cause (35-47%) mortality were evident for men who reported cigarette smoking cessation by the end of the trial compared with those continuing to smoke. There was no evidence that lung cancer death rates were lower among cigarette smokers who quite compared with those who continued to smoke in this 10-year follow-up period.
The data are consistent with results of previous epidemiologic studies indicating that the benefits of smoking cessation on CHD are rapid, while for lung cancer, the benefit is not evident in a 10-year follow-up period.
在接受多重危险因素干预试验（MRFIT）筛查的男性以及随机分组的男性中，研究吸烟及戒烟与死亡率之间的关系。
在接受MRFIT筛查的361,662名男性中，吸烟是全因、冠心病（CHD）、中风和癌症死亡的重要危险因素。在对数相对尺度上，这些风险在肺癌、口腔癌和喉癌中最为强烈。吸烟相关的额外风险在冠心病死亡中最大。总体而言，约一半的死亡与吸烟有关。在12,866名随机参与者中，发现吸烟习惯持续时间以及焦油和尼古丁水平与全因死亡率存在微弱的正相关。对于筛查入组（SI）和未筛查入组（UC）的男性，在试验结束时报告戒烟的男性与继续吸烟的男性相比，后续冠心病（34 - 49%）和全因（35 - 47%）死亡率存在显著差异。在这10年的随访期内，没有证据表明戒烟者的肺癌死亡率低于继续吸烟者。
这些数据与先前的流行病学研究结果一致，表明戒烟对冠心病的益处迅速，而对于肺癌，在10年的随访期内益处不明显。
