Public Health, Department of Social and Environmental Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan.
Prev Med. 2012 Dec;55(6):639-43. doi: 10.1016/j.ypmed.2012.09.006. Epub 2012 Sep 13.
To investigate an effect of smoking cessation on chronic obstructive pulmonary disease (COPD) mortality in Asians.
The data was obtained from the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). A total of 41465 Japanese men and 52662 Japanese women aged 40-79 years who had no history of COPD, asthma, other chronic lung diseases, cardiovascular disease or cancer were followed between 1988 and 2008.
During median 18-year of follow-up, there were 285 (251 men and 34 women) documented deaths from COPD. Multivariable-adjusted hazard ratios with 95% confidence intervals of COPD death were 4.46 (2.72-7.29) and 9.26 (4.19-20.5), respectively for current male and female smokers when compared to never smokers. Compared with current smokers, the multivariable HRs for 5-9 years and 10 years or more smoking cessation prior to baseline were 0.44 (0.22-0.87) and 0.36 (0.22-0.58) in men, respectively while the HR for never smokers was 0.30 (0.16-0.57). There were an insufficient number of COPD deaths in women to clarify this association.
Smoking cessation for ten years or more prior to enrollment reverses the excess risk of COPD mortality to a level similar to that observed among never smokers in men.
探讨戒烟对亚洲慢性阻塞性肺疾病（COPD）死亡率的影响。
数据来自日本癌症风险合作队列研究（JACC 研究）。共纳入 41465 名年龄在 40-79 岁之间、无 COPD、哮喘、其他慢性肺部疾病、心血管疾病或癌症病史的日本男性和 52662 名日本女性，随访时间为 1988 年至 2008 年。
在中位 18 年的随访期间，共有 285 人（251 名男性和 34 名女性）确诊死于 COPD。多变量调整后的 COPD 死亡风险比（95%置信区间）分别为男性当前吸烟者 4.46（2.72-7.29）和女性当前吸烟者 9.26（4.19-20.5），与从不吸烟者相比。与当前吸烟者相比，在基线前戒烟 5-9 年和 10 年或以上的男性多变量 HR 分别为 0.44（0.22-0.87）和 0.36（0.22-0.58），而从不吸烟者的 HR 为 0.30（0.16-0.57）。女性 COPD 死亡人数不足，无法明确这种关联。
在入组前戒烟 10 年或以上可使男性 COPD 死亡率的超额风险降至与从不吸烟者相似的水平。
