Christopoulou Rebekka, Lillard Dean R
Rebekka Christopoulou is with the Department of Economic Sciences, University of Macedonia, Thessaloniki, Greece. Dean R. Lillard is with the Department of Human Sciences, The Ohio State University, Columbus; Deutsches Institut Für Wirtschaftsforschung, Berlin, Germany; and the National Bureau of Economic Research, Cambridge, MA.
Am J Public Health. 2016 Jul;106(7):1329-35. doi: 10.2105/AJPH.2016.303130. Epub 2016 Apr 14.
To develop a smoking indicator that combines the popularity and duration of smoking and the quantity and quality of consumed cigarettes, factors that vary dramatically over time and across generations.
We used retrospective reports on smoking behavior and a time series of cigarette tar yields to standardize nationally representative life-course smoking prevalence rates of 11 generations of US men and women, spanning 120 years. For each generation and gender, we related the standardized data with the corresponding rates of smoking-attributable mortality.
Our indicator suggests that US cigarette consumption spread, peaked, and contracted faster than commonly perceived; predicts a significantly stronger smoking-mortality correlation than unadjusted smoking prevalence; and reveals the emergence of a delay (by up to 8 years) in premature death from smoking that is consistent with increasing population access to effective treatments. In fact, we show that, among recent cohorts, smoking health-risk exposure is at a historic low and will account for less than 5% of deaths.
Relative to unstandardized measures, our novel, standardized indicator of smoking prevalence describes a different history of smoking diffusion in the United States, and more strongly predicts later-life mortality.
开发一种吸烟指标，该指标综合考虑吸烟的流行程度、持续时间以及所消费香烟的数量和质量，这些因素会随时间和代际发生显著变化。
我们利用关于吸烟行为的回顾性报告以及一系列香烟焦油含量数据，对跨越120年的11代美国男性和女性具有全国代表性的终生吸烟流行率进行标准化。对于每一代和每一种性别，我们将标准化数据与相应的吸烟归因死亡率进行关联。
我们的指标表明，美国香烟消费的传播、达到峰值和收缩速度比通常认为的要快；预测吸烟与死亡率之间的相关性比未经调整 的吸烟流行率显著更强；并揭示了吸烟导致过早死亡出现延迟（长达8年），这与越来越多的人能够获得有效治疗一致。事实上，我们表明，在最近几代人中，吸烟对健康的风险暴露处于历史低位，且将占死亡人数的比例不到5%。
相对于未标准化的测量方法，我们新颖的、标准化的吸烟流行率指标描述了美国吸烟传播的不同历史，并且更有力地预测了晚年死亡率。
