Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, Maryland.
Information Management Services, Inc., Calverton, Maryland.
Am J Prev Med. 2019 Jan;56(1):27-37. doi: 10.1016/j.amepre.2018.06.025. Epub 2018 Oct 24.
Worldwide, an estimated 189 million adults smoke tobacco "occasionally" but not every day. Yet few studies have examined the health risks of non-daily smoking.
Data from the 1991, 1992, and 1995 U.S. National Health Interview Surveys, a nationally representative sample of 70,913 U.S. adults (aged 18-95 years) were pooled. Hazard ratios and 95% CIs for death through 2011 were estimated from Cox proportional hazards regression using age as the underlying time metric and stratified by 5-year birth cohorts in 2017.
Non-daily smokers reported smoking a median of 15 days and 50 cigarettes per month in contrast to daily smokers who smoked a median of 600 cigarettes per month. Compared with never smokers, lifelong nondaily smokers who had never smoked daily had a 72% higher mortality risk (95% CI=1.36, 2.18): higher risks were observed for cancer, heart disease, and respiratory disease mortalities. Higher mortality risks were observed among lifelong non-daily smokers who reported 11-30 (hazard ratio=1.34, 95% CI=0.81, 2.20); 31-60 (hazard ratio=2.02, 95% CI=1.17, 3.29); and >60 cigarettes per month (hazard ratio=1.74, 95% CI=1.12, 2.72) than never smokers. Median life-expectancy was about 5 years shorter for lifelong non-daily smokers than never smokers. As expected, daily smokers had even higher mortality risks (hazard ratio=2.50, 95% CI=2.35, 2.66) and shorter survival (10 years less).
Although the mortality risks of non-daily smokers are lower than daily smokers, they are still substantial. Policies should be specifically directed at this growing group of smokers.
在全球范围内，估计有 1.89 亿成年人偶尔吸烟但并非每天吸烟。然而，很少有研究探讨非每日吸烟的健康风险。
数据来自于 1991 年、1992 年和 1995 年美国国家健康访谈调查，这是一项对 70913 名美国成年人（年龄在 18-95 岁之间）的全国代表性样本进行的调查。使用 Cox 比例风险回归，以年龄为基础时间指标，并按 2017 年的 5 岁出生队列分层，对截至 2011 年的死亡风险比和 95%置信区间进行了估计。
非每日吸烟者报告每月平均吸烟 15 天，50 支香烟，而每日吸烟者每月平均吸烟 600 支香烟。与从不吸烟者相比，终生非每日吸烟者且从不每日吸烟的死亡风险高出 72%（95%CI=1.36，2.18）：癌症、心脏病和呼吸道疾病死亡率的风险更高。对于报告每月吸烟 11-30 支（风险比=1.34，95%CI=0.81，2.20）、31-60 支（风险比=2.02，95%CI=1.17，3.29）和>60 支香烟的终生非每日吸烟者，观察到更高的死亡率风险（风险比=1.74，95%CI=1.12，2.72），而从不吸烟者的风险比=1.74，95%CI=1.12，2.72）。终生非每日吸烟者的预期寿命比从不吸烟者短约 5 年。正如预期的那样，每日吸烟者的死亡率风险更高（风险比=2.50，95%CI=2.35，2.66），生存时间更短（少 10 年）。
尽管非每日吸烟者的死亡率风险低于每日吸烟者，但仍然相当高。政策应专门针对这一不断增长的吸烟群体。
