Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health (NDPH), University of Oxford, Oxford, UK.
School of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
Int J Epidemiol. 2021 Jul 9;50(3):955-964. doi: 10.1093/ije/dyab013.
Research is needed to determine the relevance of low-intensity daily smoking to mortality in countries such as Mexico, where such smoking habits are common.
Prospective study of 159 755 Mexican adults recruited from 1998-2004 and followed for cause-specific mortality to 1 January 2018. Participants were categorized according to baseline self-reported smoking status. Confounder-adjusted mortality rate ratios (RRs) at ages 35-89 were estimated using Cox regression, after excluding those with previous chronic disease (to avoid reverse causality).
Among 42 416 men and 86 735 women aged 35-89 and without previous disease, 18 985 men (45%) and 18 072 women (21%) reported current smoking and 8866 men (21%) and 53 912 women (62%) reported never smoking. Smoking less than daily was common: 33% of male current smokers and 39% of female current smokers. During follow-up, the all-cause mortality RRs associated with the baseline smoking categories of <10 cigarettes per day (average during follow-up 4 per day) or ≥10 cigarettes per day (average during follow-up 10 per day), compared with never smoking, were 1.17 (95% confidence interval 1.10-1.25) and 1.54 (1.42-1.67), respectively. RRs were similar irrespective of age or sex. The diseases most strongly associated with daily smoking were respiratory cancers, chronic obstructive pulmonary disease and gastrointestinal and vascular diseases. Ex-daily smokers had substantially lower mortality rates than those who were current daily smokers at recruitment.
In this Mexican population, low-intensity daily smoking was associated with increased mortality. Of those smoking 10 cigarettes per day on average, about one-third were killed by their habit. Quitting substantially reduced these risks.
需要研究在墨西哥等国家，低强度每日吸烟与死亡率的相关性，因为这些国家存在这种吸烟习惯。
这是一项对 1998 年至 2004 年间招募的 159755 名墨西哥成年人进行的前瞻性研究，随访至 2018 年 1 月 1 日的特定原因死亡率。参与者根据基线自我报告的吸烟状况进行分类。在排除有既往慢性疾病的个体（以避免反向因果关系）后，使用 Cox 回归估计 35-89 岁时的混杂因素调整死亡率比（RR）。
在 35-89 岁且无既往疾病的 42416 名男性和 86735 名女性中，18985 名男性（45%）和 18072 名女性（21%）报告目前吸烟，8866 名男性（21%）和 53912 名女性（62%）报告从不吸烟。每日吸烟量较少很常见：33%的男性现吸烟者和 39%的女性现吸烟者。在随访期间，与从不吸烟相比，每天吸烟<10 支（平均每天 4 支）或每天吸烟≥10 支（平均每天 10 支）的基线吸烟类别相关的全因死亡率 RR 分别为 1.17（95%置信区间 1.10-1.25）和 1.54（1.42-1.67）。RR 与年龄或性别无关。与每日吸烟最密切相关的疾病是呼吸道癌症、慢性阻塞性肺疾病和胃肠道及血管疾病。与招募时的每日吸烟者相比，前每日吸烟者的死亡率要低得多。
在墨西哥人群中，低强度每日吸烟与死亡率增加有关。在每天吸烟 10 支的人群中，约有三分之一因吸烟而死亡。戒烟可显著降低这些风险。
