Xu Wang-Hong, Zhang Xiang-Lan, Gao Yu-Tang, Xiang Yong-Bing, Gao Li-Feng, Zheng Wei, Shu Xiao-Ou
Department of Epidemiology, Cancer Institute of Shanghai Jiaotong University, Shanghai Cancer Institute, Shanghai 200032, People's Republic of China.
Prev Med. 2007 Oct;45(4):313-9. doi: 10.1016/j.ypmed.2007.05.015. Epub 2007 Jun 2.
To evaluate the joint effect of cigarette smoking and alcohol consumption on mortality.
A population-based cohort of 66,743 Chinese men aged 30-89 in Shanghai, China recruited from 1996 to 2000. Lifestyle data were collected using structured questionnaires. As of November 2004, follow-up for the vital status of 64,515 men was completed and death information was further confirmed through record linkage with the Shanghai Vital Statistics Registry. Associations were evaluated by Cox regression analyses.
2514 deaths (982 from cancers, 776 from cardiovascular diseases (CVD)) were identified during 297,396 person-years of follow-up. Compared to never-smokers, both former and current smokers had significantly elevated mortality from any cause, CVD, and cancer; risk increased with amount of smoking. Intake of 1-7 drinks/week was associated with reduced risk of death, particularly CVD death (hazard ratio (HR): 0.7, 95% confidence interval (CI): 0.5, 1.0), whereas intake of >42 drinks/week was related to increased mortality, particularly cancer-related death (HR: 1.7, 95% CI: 1.1, 2.5). The HR for total mortality associated with moderate alcohol consumption increased from 0.8 (95% CI: 0.6, 1.0) for non-smokers to 1.0 (0.9, 1.2) for moderate smokers and 1.4 (95% CI: 1.2, 1.7) for heavy smokers. Heavy drinkers and heavy smokers had the highest mortality (HR: 1.9, 95% CI: 1.6, 2.4).
Light and moderate alcohol consumption reduced mortality from CVD. This beneficial effect, however, was offset by cigarette smoking.
评估吸烟与饮酒对死亡率的联合影响。
对1996年至2000年在中国上海招募的66743名年龄在30 - 89岁的中国男性进行基于人群的队列研究。使用结构化问卷收集生活方式数据。截至2004年11月，完成了对64515名男性生命状态的随访，并通过与上海生命统计登记处的记录链接进一步确认了死亡信息。通过Cox回归分析评估关联。
在297396人年的随访期间，共确定2514例死亡（982例死于癌症，776例死于心血管疾病（CVD））。与从不吸烟者相比，既往吸烟者和当前吸烟者的全因死亡率、CVD死亡率和癌症死亡率均显著升高；风险随吸烟量增加而增加。每周饮用1 - 7杯酒与死亡风险降低相关，尤其是CVD死亡（风险比（HR）：0.7，95%置信区间（CI）：0.5，1.0），而每周饮用超过42杯酒与死亡率增加相关，尤其是癌症相关死亡（HR：1.7，95% CI：1.1，2.5）。与适度饮酒相关的全因死亡率HR从非吸烟者的0.8（95% CI：0.6，1.0）增加到适度吸烟者的1.0（0.9，1.2）和重度吸烟者的1.4（95% CI：1.2，1.7）。重度饮酒者和重度吸烟者的死亡率最高（HR：1.9，95% CI：1.6，2.4）。
轻度和适度饮酒可降低CVD死亡率。然而，这种有益作用被吸烟所抵消。
