Pelletier F, Marcil-Gratton N, Légaré J
Département de démographie, Université de Montréal, Québec, Canada.
Prev Med. 1996 Nov-Dec;25(6):730-40. doi: 10.1006/pmed.1996.0113.
Cigarette smoking is the No. 1 cause of premature death among Canadians. However, tobacco consumption dropped by 35% in Canada during the 1980s.
Using data collected during a Quebec health survey, we evaluated the prevalences of tobacco use by birth cohort. Since mortality has been decreasing for both sexes, we computed gender-specific cohort mortality indices for tobacco-related causes of death. In the analysis, we took into account the inevitable time lag between adopting the behavior and becoming the victim of a smoking-attributable disease.
Results indicate a systematic decrease in tobacco use from older male cohorts to younger ones across all ages; however, for females an increase in tobacco use has been observed from one cohort to the next but there seems to be hope for a future trend toward breaking the habit. While a decline in tobacco-related mortality has been observed among men (e.g., death from ischemic heart disease), female lung cancer mortality increased considerably. Finally, we present an indicator measuring the years of potential life lost for some tobacco-related causes of death.
The cohort approach allows us to observe birth-cohort-specific trends, thereby more easily relating past behavior to current mortality levels. In terms of prevention, increasing female mortality from lung cancer should become a major concern and a motivator in the fight against tobacco use.
吸烟是加拿大过早死亡的首要原因。然而，在20世纪80年代，加拿大的烟草消费量下降了35%。
利用在魁北克健康调查期间收集的数据，我们按出生队列评估了烟草使用的患病率。由于两性的死亡率一直在下降，我们计算了与烟草相关死因的特定性别队列死亡率指数。在分析中，我们考虑了采取该行为与成为吸烟所致疾病受害者之间不可避免的时间间隔。
结果表明，所有年龄段的男性，从年长队列到年轻队列，烟草使用呈系统性下降；然而，对于女性而言，观察到从一个队列到下一个队列烟草使用有所增加，但未来似乎有望出现打破这一习惯的趋势。虽然在男性中观察到与烟草相关的死亡率有所下降（例如，缺血性心脏病死亡），但女性肺癌死亡率大幅上升。最后，我们提出了一个指标，用于衡量某些与烟草相关死因导致的潜在寿命损失年数。
队列研究方法使我们能够观察特定出生队列的趋势，从而更容易将过去的行为与当前的死亡率水平联系起来。在预防方面，女性肺癌死亡率上升应成为抗击烟草使用的主要关注点和推动因素。
