Epidemiology and Public Health, Sciensano, Brussels, Belgium.
Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium.
Eur J Public Health. 2018 Oct 1;28(5):859-863. doi: 10.1093/eurpub/cky101.
Smoking is the leading cause of premature mortality and morbidity. This study aimed at assessing the impact of smoking on life expectancy (LE) and LE with (LED) and without disability (DFLE). We further estimated the contribution of disability and mortality and their causes to differences in LED and DFLE by smoking.
Data on disability, chronic conditions, and smoking from 17 148 participants of the 1997, 2001, 2004 Belgian Health Interview Surveys were used to estimate causes of disability using the attribution method. A 10-year mortality follow-up of survey participants was used. The Sullivan method was applied to estimate LED and DFLE. The contribution of disability and mortality and of causes of disability and death to smoking differences in LED and DFLE was assessed using decomposition methods.
Never smokers live longer than daily smokers. DFLE advantage at age 15 of +8.5/+4.3 years (y) in men/women never compared with daily smokers was the result of lower mortality (+6.2y/+3y) and lower disability (2.3y/1.3y). The extra 0.3y/1.6y LED in never smokers was due to lower mortality (+2.6y/+2.9y) and lower disability (-2.3y/-1.3y). Lower mortality from lung/larynx/trachea cancer, chronic respiratory, and ischaemic heart diseases was the main contributor to higher LED and DFLE in never smokers. Lower disability from musculoskeletal conditions in men and chronic respiratory diseases in women increased LED and DFLE in never smokers.
Mortality and disability advantage among never smokers contributed to longer DFLE, while mortality advantage contributed to their longer LED.
吸烟是导致早逝和发病的主要原因。本研究旨在评估吸烟对预期寿命（LE）和有（LED）和无残疾（DFLE）的预期寿命的影响。我们进一步估计了残疾和死亡率及其原因对吸烟导致的 LED 和 DFLE 差异的贡献。
使用来自 1997 年、2001 年和 2004 年比利时健康访谈调查的 17148 名参与者的残疾、慢性疾病和吸烟数据，使用归因方法估计残疾的原因。对调查参与者进行了 10 年的死亡率随访。应用 Sullivan 法估计 LE 和 DFLE。使用分解方法评估残疾和死亡率以及残疾和死亡原因对 LED 和 DFLE 中吸烟差异的贡献。
从不吸烟者比每日吸烟者寿命更长。15 岁时从不吸烟者与每日吸烟者相比，男性/女性的 DFLE 优势为+8.5/+4.3 年（y），这是由于死亡率较低（+6.2y/+3y）和残疾率较低（2.3y/1.3y）。从不吸烟者的额外 0.3y/1.6y 的 LED 是由于死亡率较低（+2.6y/+2.9y）和残疾率较低（-2.3y/-1.3y）。肺癌/喉癌/气管癌、慢性呼吸道疾病和缺血性心脏病的死亡率降低是从不吸烟者 LED 和 DFLE 较高的主要原因。男性的肌肉骨骼疾病和女性的慢性呼吸道疾病残疾率降低增加了从不吸烟者的 LED 和 DFLE。
从不吸烟者的死亡率和残疾优势导致了更长的 DFLE，而死亡率优势导致了更长的 LED。
