Am J Epidemiol. 2014 May 1;179(9):1060-70. doi: 10.1093/aje/kwu011. Epub 2014 Mar 27.
Prospective evidence of the associations of smoking cessation with chronic obstructive pulmonary disease (COPD) and other causes of death in Asia is scarce. Previous studies, which were mostly based on baseline smoking behavior only, were subject to sick-quitter bias and misclassification resulting from changes in smoking behavior during follow-up. We followed up a cohort for 18 years (1976-1994) to assess changes in smoking behavior and then for an additional 17 years (1994-2011) to examine the relationships of continuing to smoke and new quitting with mortality risk in 1,494 Chinese people (961 men, 533 women). Of the baseline current smokers, 38.7% quit between 1976 and 1994. From 1994 to 2011, a total of 488 persons (359 men, 129 women) died. Ever smokers had increased risks of lung cancer, coronary heart disease, thrombotic stroke, and COPD, with dose-response relationships. For all tobacco-related mortality, the relative risk for new quitters compared with continuing smokers was 0.68 (95% confidence interval: 0.46, 0.99) for those who had quit 2-7 years previously and 0.56 (95% confidence interval: 0.37, 0.85) for those who had quit 8 years or more previously. The corresponding relative risks were 0.69 and 0.45 for lung cancer, 0.78 and 0.51 for coronary heart disease, 0.76 and 0.84 for thrombotic stroke, and 0.89 and 0.61 for COPD, respectively. Smoking increased tobacco-related deaths, and particularly deaths from COPD, in China, whereas quitting at middle age (at approximately 50 years of age) substantially reduced the risks of death from these causes. The benefits of smoking cessation were underestimated in previous studies that did not use repeated measures.
在亚洲，关于戒烟与慢性阻塞性肺疾病（COPD）和其他死因之间关联的前瞻性证据很少。之前的研究大多仅基于基线吸烟行为，受到患病戒烟偏倚和随访期间吸烟行为变化导致的分类错误的影响。我们对一个队列进行了 18 年（1976-1994 年）的随访，以评估吸烟行为的变化，然后又进行了 17 年（1994-2011 年）的随访，以研究持续吸烟和新戒烟与 1494 名中国人（961 名男性，533 名女性）的死亡风险之间的关系。在基线时的当前吸烟者中，38.7%在 1976 年至 1994 年期间戒烟。从 1994 年到 2011 年，共有 488 人（359 名男性，129 名女性）死亡。曾经吸烟者的肺癌、冠心病、血栓性中风和 COPD 风险增加，呈剂量反应关系。对于所有与烟草相关的死亡，与继续吸烟者相比，戒烟 2-7 年的新发戒烟者的相对风险为 0.68（95%置信区间：0.46，0.99），戒烟 8 年或以上的新发戒烟者的相对风险为 0.56（95%置信区间：0.37，0.85）。相应的相对风险分别为肺癌 0.69 和 0.45，冠心病 0.78 和 0.51，血栓性中风 0.76 和 0.84，COPD 0.89 和 0.61。吸烟增加了中国与烟草相关的死亡，特别是 COPD 死亡，而中年（约 50 岁）戒烟可大大降低这些原因导致的死亡风险。之前没有使用重复测量的研究低估了戒烟的益处。
