Pham Truong-Minh, Fujino Yoshihisa, Ide Reiko, Shirane Kiyoyumi, Tokui Noritaka, Kubo Tatsuhiko, Mizoue Tetsuya, Ogimoto Itsuro, Yoshimura Takesumi
Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu 807-8555, Japan.
Eur J Epidemiol. 2007;22(9):599-605. doi: 10.1007/s10654-007-9161-y. Epub 2007 Jul 25.
We conducted this study to estimate the association and population attributable risk (PAR) of smoking with all-cause and cause-specific mortality based on a general prospective cohort study in Japan. A total of 8,129 subjects (3,996 males and 4,133 females) aged 40 or over were analyzed. The follow-up period was from 1986 to 2003. Smoking habit was classified into three categories of never smoker, former smoker, and current smoker. The Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI). We also estimated the PAR of smoking, and calculated the 95% CI of PAR based on the bootstrap procedure. A total of 112,151 person-years were counted for 8,129 subjects over an average of 13.7 years of follow-up. The results showed that smoking increased the risk of dying from all cancers, cardiovascular, and respiratory diseases in both sexes. For all causes of death, smokers had a HR of 1.30 (95% CI: 1.09, 1.54), PAR of 13.1% (95% CI: 7.6, 22.3) in males, and HR of 1.81 (95% CI: 1.43, 2.29), and PAR of 6.1% (95% CI: 3.1, 9.3) in females compared to never smokers. These results confirm an increased risk of mortality from all causes, as well as from all cancers, cardiovascular disease, and respiratory disease in relation to smoking habit. Smoking is responsible for a considerable proportion of deaths due to all causes as well as cause-specific deaths. Population-based antismoking programs should be implemented to reduce such avoidable deaths.
我们开展这项研究，旨在基于日本一项普通前瞻性队列研究，评估吸烟与全因死亡率及特定病因死亡率之间的关联以及人群归因风险（PAR）。总共分析了8129名40岁及以上的受试者（3996名男性和4133名女性）。随访期为1986年至2003年。吸烟习惯分为从不吸烟者、既往吸烟者和当前吸烟者三类。采用Cox比例风险模型来估计风险比（HR）和95%置信区间（95%CI）。我们还估计了吸烟的PAR，并基于自助法计算了PAR的95%CI。8129名受试者在平均13.7年的随访期内共计112151人年。结果显示，吸烟增加了男女因所有癌症、心血管疾病和呼吸系统疾病死亡的风险。对于所有死因，与从不吸烟者相比，男性吸烟者的HR为1.30（95%CI：1.09，1.54），PAR为13.1%（95%CI：7.6，22.3），女性吸烟者的HR为1.81（95%CI：1.43，2.29），PAR为6.1%（95%CI：3.1，9.3）。这些结果证实，与吸烟习惯相关的全因死亡率以及所有癌症、心血管疾病和呼吸系统疾病的死亡率均有所增加。吸烟导致了相当比例的全因死亡以及特定病因死亡。应实施基于人群的反吸烟项目以减少此类可避免的死亡。
