Population Research Unit, Department of Social Research University of Helsinki, PO Box 18, Helsinki FIN-00014, Finland.
J Epidemiol Community Health. 2013 Mar;67(3):219-24. doi: 10.1136/jech-2012-201266. Epub 2012 Nov 30.
We estimated the contribution of smoking to educational differences in mortality and life expectancy between 1971 and 2010 in Finland.
Eight prospective datasets with baseline in 1970, 1975, 1980, 1985, 1990, 1995, 2000 and 2005 and each linked to a 5-year mortality follow-up were used. We calculated life expectancy at age 50 years with and without smoking-attributable mortality by education and gender. Estimates of smoking-attributable mortality were based on an indirect method that used lung cancer mortality as a proxy for the impact of smoking on mortality from all other causes.
Smoking-attributable deaths constituted about 27% of all male deaths above age 50 years in the early 1970s and 17% in the period 2006-2010; these figures were 1% and 4% among women, respectively. The life expectancy differential between men with basic versus high education increased from 3.4 to 4.7 years between 1971-1975 and 2006-2010. In the absence of smoking, these differences would have been 1.5 and 3.4 years, 1.9 years (55%) and 1.3 years (29%) less than those observed. Among women, educational differentials in life expectancy between the most and least educated increased from 2.5 to 3.0 years. This widening was nearly entirely accounted for by the increasing impact of smoking. Among women the contribution of smoking to educational differences had increased from being negligible in 1971-1975 to 16% in 2006-2010.
Among men, the increase in educational differences in mortality in the past decades was driven by factors other than smoking. However, smoking continues to have a major influence on educational differences in mortality among men and its contribution is increasing among women.
我们估计了吸烟对芬兰 1971 年至 2010 年期间死亡率和预期寿命的教育差异的贡献。
使用了八个前瞻性数据集，其基线在 1970 年、1975 年、1980 年、1985 年、1990 年、1995 年、2000 年和 2005 年，每个数据集都与五年的死亡率随访数据相关联。我们根据教育和性别计算了 50 岁时的预期寿命，包括和不包括与吸烟有关的死亡率。吸烟归因死亡率的估计值基于一种间接方法，该方法使用肺癌死亡率作为吸烟对所有其他原因导致的死亡率影响的替代指标。
在 20 世纪 70 年代早期，吸烟归因死亡占所有男性 50 岁以上死亡人数的 27%，而在 2006-2010 年期间则占 17%；女性分别为 1%和 4%。在没有吸烟的情况下，1971-1975 年和 2006-2010 年期间，男性接受基本教育和高教育的预期寿命差异从 3.4 年增加到 4.7 年。如果没有吸烟，这些差异将分别减少 1.5 年和 3.4 年，减少 1.9 年（55%）和 1.3 年（29%）。在女性中，最受教育和最不受教育的人之间的预期寿命差异从 2.5 年增加到 3.0 年。这种扩大几乎完全是由吸烟影响的增加造成的。在女性中，吸烟对教育差异的贡献从 1971-1975 年的微不足道增加到 2006-2010 年的 16%。
在男性中，过去几十年中死亡率的教育差异增加的原因并非吸烟。然而，吸烟对男性死亡率的教育差异仍有重大影响，而且这种影响在女性中正在增加。
