Centre for Population & Health Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Public Health & Health Policy, 1 Lilybank Gardens, Glasgow G12 8RZ, UK.
BMC Public Health. 2010 Dec 24;10:789. doi: 10.1186/1471-2458-10-789.
Smoking and consuming alcohol are both related to increased mortality risk. Their combined effects on cause-specific mortality were investigated in a prospective cohort study.
Participants were 5771 men aged 35-64, recruited during 1970-73 from various workplaces in Scotland. Data were obtained from a questionnaire and a screening examination. Causes of death were all cause, coronary heart disease (CHD), stroke, alcohol-related, respiratory and smoking-related cancer. Participants were divided into nine groups according to their smoking status (never, ex or current) and reported weekly drinking (none, 1-14 units and 15 or more). Cox proportional hazards models were used to obtain relative rates of mortality, adjusted for age and other risk factors.
In 30 years of follow-up, 3083 men (53.4%) died. Compared with never smokers who did not drink, men who both smoked and drank 15+ units/week had the highest all-cause mortality (relative rate = 2.71 (95% confidence interval 2.31-3.19)). Relative rates for CHD mortality were high for current smokers, with a possible protective effect of some alcohol consumption in never smokers. Stroke mortality increased with both smoking and alcohol consumption. Smoking affected respiratory mortality with little effect of alcohol. Adjusting for a wide range of confounders attenuated the relative rates but the effects of alcohol and smoking still remained. Premature mortality was particularly high in smokers who drank 15 or more units, with a quarter of the men not surviving to age 65. 30% of men with manual occupations both smoked and drank 15+ units/week compared with only 13% with non-manual ones.
Smoking and drinking 15+ units/week was the riskiest behaviour for all causes of death.
吸烟和饮酒都与死亡率增加有关。本前瞻性队列研究旨在调查它们对特定病因死亡率的综合影响。
参与者为 5771 名年龄在 35-64 岁的男性，于 1970-1973 年期间在苏格兰不同工作场所招募。数据来自问卷调查和筛查检查。所有死因、冠心病（CHD）、中风、与酒精相关、与呼吸相关和与吸烟相关的癌症。参与者根据吸烟状况（从不、曾经或当前）和报告的每周饮酒量（无、1-14 单位和 15 单位或更多）分为 9 组。使用 Cox 比例风险模型获得死亡率的相对比率，同时调整年龄和其他危险因素。
在 30 年的随访中，3083 名男性（53.4%）死亡。与从不饮酒且不吸烟的男性相比，既吸烟又每周饮酒 15 单位或以上的男性全因死亡率最高（相对比率=2.71（95%置信区间 2.31-3.19））。当前吸烟者的 CHD 死亡率也很高，从不吸烟者的一些饮酒可能有保护作用。中风死亡率随吸烟和饮酒而增加。吸烟对呼吸系死亡率有影响，而饮酒的影响较小。调整广泛的混杂因素后，相对比率减弱，但酒精和吸烟的影响仍然存在。每周饮酒 15 单位或以上且吸烟的男性过早死亡的风险特别高，四分之一的男性未能活到 65 岁。有 30%的体力劳动者同时吸烟且每周饮酒 15 单位或以上，而非体力劳动者只有 13%。
每周吸烟且饮酒 15 单位或以上是所有死因的最危险行为。
