Vogt M T, Cauley J A, Scott J C, Kuller L H, Browner W S
Department of Orthopaedic Surgery, School of Medicine, University of Pittsburgh, PA, USA.
Arch Intern Med. 1996 Mar 25;156(6):630-6.
Relatively few studies have been focused on the effect of smoking among older individuals. The goal of this study is to investigate the relationship between smoking status and cause-and age-specific mortality among elderly women.
Women aged 65 years and older and living in four geographical areas (Baltimore, Md, Minneapolis, Minn, Pittsburgh, Pa, and Portland, Ore) were recruited from various population-based listings for participation in the multicenter Study of Osteoporotic Fractures between September 1986 and October 1988 (N=9704). During a mean follow-up of 4.9 years (<99% complete), 751 deaths occurred. The date and cause of death were ascertained, and the relationship between mortality and current and past smoking status was analyzed using Cox proportional hazards modeling techniques.
Compared with nonsmokers, women smokers aged 65 to 74 years have a more than twofold increase in mortality attributable to increases in both cardiovascular and cancer mortality; death from smoking-related cancers increased eight- to 10-fold. Women 75 years and older who smoke have a small overall increased relative risk (RR) of mortality (RR=1.4; 95% confidence interval [CI], 0.9 to 2.3), but more than five-fold increased risk of dying from a smoking-related cancer (RR=5.2; 95% CI, 1.6 to 16.8). All-cause and cardiovascular death rates approach those of nonsmokers within 10 years after a woman quits smoking; morality from smoking-related cancers remains elevated for at least 23 years.
The harmful effects of continuing to smoke are apparent even among women aged 75 years and older.
相对较少的研究关注吸烟对老年人的影响。本研究的目的是调查老年女性吸烟状况与特定病因及年龄别死亡率之间的关系。
1986年9月至1988年10月期间，从多个基于人群的列表中招募了年龄在65岁及以上、居住在四个地理区域（马里兰州巴尔的摩、明尼苏达州明尼阿波利斯、宾夕法尼亚州匹兹堡和俄勒冈州波特兰）的女性，参与骨质疏松性骨折多中心研究（N = 9704）。在平均4.9年的随访期间（完成率<99%），发生了751例死亡。确定了死亡日期和原因，并使用Cox比例风险建模技术分析了死亡率与当前和过去吸烟状况之间的关系。
与不吸烟者相比，65至74岁的女性吸烟者因心血管疾病和癌症死亡率增加，死亡率增加了两倍多；与吸烟相关癌症的死亡增加了八至十倍。75岁及以上吸烟的女性总体死亡相对风险（RR）略有增加（RR = 1.4；95%置信区间[CI]，0.9至2.3），但因吸烟相关癌症死亡的风险增加了五倍多（RR = 5.2；95% CI，1.6至16.8）。女性戒烟后10年内，全因和心血管死亡率接近不吸烟者；与吸烟相关癌症的死亡率至少在23年内仍居高不下。
即使在75岁及以上的女性中，继续吸烟的有害影响也很明显。
