School of Public Health, the University of Hong Kong, Hong Kong SAR, China.
School of Public Health, Sun Yat-sen University, Guangzhou, China.
PLoS One. 2018 Apr 26;13(4):e0196610. doi: 10.1371/journal.pone.0196610. eCollection 2018.
Prediction of disease burden in China arising from smoking based on earlier cohorts in the West and China could not reflect the disease burden at the current stage accurately. No cohort studies in China focused specifically on people born since 1950. We examined the risk of all-cause mortality attributed to smoking in adults in Guangzhou, the city with the most rapidly expanding economy in China.
This population-based prospective cohort included 21,658 women and 8,284 men aged 50+ years enrolled from 2003-2008 and followed until January 2016. During an average follow-up of 8.8 (standard deviation = 1.8) years, 2,986 (1,586 women, 1,400 men) deaths were recorded. After adjustment for confounders, the hazards ratios (95% confidence interval (CI)) of all-cause mortality in current versus never smokers increased from 1.61 (95% CI 1.45-1.80) in those born in 1920-1939 to 2.02 (95% CI 1.74-2.34), and 4.40 (95% CI 3.14-6.17), in those born in the 1940s and 1950s, respectively (P for trend 0.009).
In smokers born after 1949 in Guangzhou and other areas which have the longest history of smoking, the mortality risk could have reached three fold that of non-smokers, as in the UK, US and Australia. If confirmed, unless China quickly and strictly complies with the WHO Framework Convention on Tobacco Control with massive smoking cessation in the population, this is a more striking warning that China will be facing an even larger disease burden from tobacco use than previous forecasts.
基于西方和中国早期队列的研究预测中国因吸烟导致的疾病负担可能无法准确反映当前阶段的疾病负担。中国没有专门针对 1950 年后出生人群的队列研究。我们研究了广州市成年人吸烟导致的全因死亡率风险，广州是中国经济增长最快的城市。
这项基于人群的前瞻性队列研究纳入了 2003-2008 年招募的年龄在 50 岁以上的 21658 名女性和 8284 名男性，随访至 2016 年 1 月。在平均 8.8 年（标准差=1.8 年）的随访期间，记录了 2986 例（1586 名女性，1400 名男性）死亡。在调整混杂因素后，当前吸烟者与从不吸烟者相比，全因死亡率的危险比（95%置信区间（CI））从 1920-1939 年出生者的 1.61（95% CI 1.45-1.80）增加到 1940 年代和 1950 年代出生者的 2.02（95% CI 1.74-2.34）和 4.40（95% CI 3.14-6.17）（趋势 P 值=0.009）。
在广州和其他吸烟历史最长的地区，1949 年后出生的吸烟者的死亡风险可能达到不吸烟者的三倍，与英国、美国和澳大利亚相同。如果得到证实，除非中国迅速并严格遵守世界卫生组织《烟草控制框架公约》，在人群中大力戒烟，否则这将是一个更引人注目的警告，即中国将面临比以前预测更大的烟草使用疾病负担。
