Lee Peter N, Forey Barbara A, Thornton Alison J, Coombs Katharine J
P.N. Lee Statistics and Computing Ltd., Sutton, SM2 5DA, UK.
Independent Consultant in Statistics, Dartmouth, TQ6 9HB, UK.
F1000Res. 2018 Feb 19;7:204. doi: 10.12688/f1000research.14002.1. eCollection 2018.
To present up-to-date meta-analyses of evidence from Japan relating smoking to major smoking-related diseases. We restricted attention to lung cancer, chronic obstructive pulmonary disease (COPD), ischemic heart disease (IHD) and stroke, considering relative risks (RRs) for current and ex-smokers relative to never smokers. Evidence by amount smoked and time quit was also considered. For IHD and stroke only, studies had to provide age-adjusted RRs, with age-specific results considered. For each disease we extended earlier published databases to include more recent studies. Meta-analyses were conducted, with random-effects RRs and tests of heterogeneity presented. Of 40 studies, 26 reported results for lung cancer and 7 to 9 for each other disease. For current smoking, RRs (95%CIs) were lung cancer 3.59 (3.25-3.96), COPD 3.57 (2.72-4.70), IHD 2.21 (1.96-2.50) and stroke 1.40 (1.25-1.57). Ex-smoking RRs were lower. Data for lung cancer and IHD showed a clear tendency for RRs to rise with increasing amount smoked and decrease with increasing time quit. Dose-response data were unavailable for COPD and unclear for stroke, where the association was weaker. Compared to studies in other Asian and Western countries, current smoking RRs were quite similar for IHD and stroke. The comparison is not clear for COPD, where the Japanese data, mainly from cross-sectional studies, is limited. For lung cancer, the RRs are similar to those in other Asian countries, but substantially lower than in Western countries. Explanations for this are unclear, but less accurate reporting of smoking by Japanese may contribute to the difference.
呈现来自日本的关于吸烟与主要吸烟相关疾病证据的最新荟萃分析。我们将注意力集中在肺癌、慢性阻塞性肺疾病（COPD）、缺血性心脏病（IHD）和中风上，考虑当前吸烟者和既往吸烟者相对于从不吸烟者的相对风险（RRs）。还考虑了按吸烟量和戒烟时间的证据。仅对于IHD和中风，研究必须提供年龄调整后的RRs，并考虑特定年龄的结果。对于每种疾病，我们扩展了早期发表的数据库以纳入更多近期研究。进行了荟萃分析，并给出了随机效应RRs和异质性检验结果。在40项研究中，26项报告了肺癌的结果，其他每种疾病报告了7至9项结果。对于当前吸烟，RRs（95%置信区间）为肺癌3.59（3.25 - 3.96），COPD 3.57（2.72 - 4.70），IHD 2.21（1.96 - 2.50）和中风1.40（1.25 - 1.57）。既往吸烟者的RRs较低。肺癌和IHD的数据显示，RRs有随吸烟量增加而升高、随戒烟时间增加而降低的明显趋势。COPD的剂量反应数据不可得，中风的数据不明确，中风的关联较弱。与其他亚洲和西方国家的研究相比，IHD和中风的当前吸烟RRs相当相似。对于COPD，比较不明确，日本的数据主要来自横断面研究，有限。对于肺癌，RRs与其他亚洲国家相似，但远低于西方国家。对此的解释尚不清楚，但日本人对吸烟情况报告的准确性较低可能导致了这种差异。
