Burch P R
Department of Medical Physics, The University of Leeds, England.
J Clin Epidemiol. 1988;41(4):373-84. doi: 10.1016/0895-4356(88)90145-x.
In an earlier paper (Burch P. R. J. J Chron Dis 1981; 34: 87-103) changes in sex- and age-specific mortality from all causes of death in England and Wales were studied in relation to changes in sex- and age-specific cigarette consumption. The absence of a consistent correlation between the two variables, and the general characteristics of the data, suggested that studies of sex ratios might provide a better test of the hypothesis that the association between smoking and mortality has a causal basis. In this paper temporal changes in the sex ratio of cumulative cigarette consumption by cohort, and of smoking rates by age, are considered in relation to changes in the sex ratio of mortality. Again, no consistent correlations emerge and it is evident that factors other than smoking have played a dominant part in determining recent changes in the sex ratio of mortality in all age groups from 35-39 to 80-84 years. Among these "other factors" are birth cohort effects that can be attributed, in part, to birth cohort changes in the sex ratio of mortality from bronchitis and emphysema. The present results, together with other evidence (vide supra; and Burch P. R. J. J Chron Dis 1984; 37: 148-156), show that great care needs to be exercised when attempts are made to deduce causation from epidemiologic surveys.
在一篇较早的论文中（伯奇P.R.J.《慢性病杂志》1981年；34卷：87 - 103页），研究了英格兰和威尔士按性别和年龄划分的全死因死亡率变化与按性别和年龄划分的香烟消费量变化之间的关系。这两个变量之间缺乏一致的相关性以及数据的总体特征表明，对性别比的研究可能会为吸烟与死亡率之间的关联具有因果基础这一假设提供更好的检验。在本文中，考虑了按队列划分的累积香烟消费量的性别比以及按年龄划分的吸烟率的时间变化与死亡率性别比变化之间的关系。同样，没有出现一致的相关性，而且很明显，除吸烟外的其他因素在决定35 - 39岁至80 - 84岁所有年龄组近期死亡率性别比变化中起了主导作用。在这些“其他因素”中，有出生队列效应，部分可归因于支气管炎和肺气肿死亡率性别比的出生队列变化。目前的结果与其他证据（见上文；以及伯奇P.R.J.《慢性病杂志》1984年；37卷：148 - 156页）表明，在试图从流行病学调查中推断因果关系时需要格外谨慎。
