Kelly Tanika N, Gu Dongfeng, Chen Jing, Huang Jian-Feng, Chen Ji-Chun, Duan Xiufang, Wu Xigui, Chen Chung-Shiuan, He Jiang
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1430 Tulane Avenue SL18, New Orleans, LA 70112, USA.
Stroke. 2008 Jun;39(6):1688-93. doi: 10.1161/STROKEAHA.107.505305. Epub 2008 Mar 6.
We studied the relationship between cigarette smoking and stroke incidence and mortality in the Chinese adult population.
We conducted a prospective cohort study in a nationally representative sample of 169 871 Chinese men and women aged 40 years and older. Data on cigarette smoking and other covariables were collected at a baseline examination in 1991 using a standard protocol. Follow-up evaluation was conducted in 1999 to 2000, with a response rate of 93.4%.
During an average of 8.3 years follow-up, a total of 6780 stroke events (3979 fatal strokes) were observed. The multivariate-adjusted relative risks (95% confidence interval) of stroke incidence and mortality associated with present cigarette smoking were 1.28 (1.19 to 1.37) and 1.13 (1.03 to 1.25) in men and 1.25 (1.13 to 1.37) and 1.19 (1.04 to 1.36) in women, respectively. The corresponding population attributable risks were 14.2% and 7.1% in men and 3.1% and 2.4% in women. Compared to never-smokers, the multivariate-adjusted relative risks of stroke incidence (95% confidence interval) were 1.21 (1.12 to 1.31), 1.21 (1.11 to 1.32), and 1.36 (1.25 to 1.47) for those who smoked 1 to 9, 10 to 19, and >/=20 cigarettes per day; and 1.18 (1.09 to 1.28), 1.25 (1.15 to 1.35), and 1.34 (1.24 to 1.44) for those who smoked 1 to 11, 12 to 26, and >26 pack-years, respectively (both P<0.0001 for linear trends).
Our study identified a positive and dose-response relationship between cigarette smoking and risk of stroke. Smoking prevention and cessation programs should be an important strategy for reducing the burden of stroke in Chinese adults.
我们研究了中国成年人群中吸烟与中风发病率及死亡率之间的关系。
我们对169871名年龄在40岁及以上具有全国代表性的中国男性和女性样本进行了一项前瞻性队列研究。1991年采用标准方案在基线检查时收集了吸烟及其他协变量的数据。1999年至2000年进行了随访评估，应答率为93.4%。
在平均8.3年的随访期间，共观察到6780例中风事件（3979例致命性中风）。当前吸烟与中风发病率及死亡率的多变量调整相对风险（95%置信区间）在男性中分别为1.28（1.19至1.37）和1.13（1.03至1.25），在女性中分别为1.25（1.13至1.37）和1.19（1.04至1.36）。相应的人群归因风险在男性中为14.2%和7.1%，在女性中为3.1%和2.4%。与从不吸烟者相比，对于每天吸1至9支、10至19支以及≥20支香烟的人群，中风发病率的多变量调整相对风险（95%置信区间）分别为1.21（1.12至1.31）、1.21（1.11至1.32）和1.36（1.25至1.47）；对于吸烟包年数为1至11、12至26以及>26的人群，中风发病率的多变量调整相对风险（95%置信区间）分别为1.18（1.09至1.28）、1.25（1.15至1.35）和1.34（1.24至1.44）（两者线性趋势的P均<0.0001）。
我们的研究确定了吸烟与中风风险之间存在正相关且呈剂量反应关系。预防吸烟和戒烟项目应成为减轻中国成年人中风负担的一项重要策略。
