 |
|
Cigarette Smoking and Mortality Risk
Twenty-five–Year Follow-up of the Seven Countries Study
David R. Jacobs, Jr, PhD;
Hisashi Adachi, MD;
Ina Mulder, MSc;
Daan Kromhout, PhD;
Alessandro Menotti, MD;
Aulikki Nissinen, MD;
Henry Blackburn, MD;
for the Seven Countries Study Group
Arch Intern Med. 1999;159:733-740.
Background Although most observations in the Seven Countries Study suggest that cigarette smoking is harmful for health, universality of this conclusion remains controversial.
Subjects and Methods Cohort-specific and pooled smoking habits at baseline (1957-1964) in 12,763 men aged 40 through 59 years living in Europe, the United States, and Japan in relation to 25-year mortality follow-up. Pooled hazard ratios for smokers vs never smokers were calculated by the Cox proportional hazards model, adjusting for baseline country of residence, age, body mass index, serum cholesterol, systolic blood pressure, and clinical cardiovascular disease.
Results Adjusted hazard ratios for all-causes death in smokers compared with never smokers were 1.3 (95% confidence interval, 1.2-1.4) for smokers of less than 10 cigarettes per day and 1.8 (95% confidence interval, 1.7-1.9) for smokers of 10 cigarettes per day or more. Hazard ratios were elevated for death due to coronary heart disease, all stroke, other arterial disease, lung cancer, other cancer, chronic obstructive pulmonary disease, and other disease in smokers compared with never smokers. Within country, a few instances in which never smokers had a higher cause-specific death rate than smokers of 10 cigarettes per day or more were attributable to random variation associated with low prevalence of never smokers and multiple comparisons.
Conclusions These findings confirm the association of cigarette smoking with elevated risk of mortality from all causes, several cardiovascular diseases, cancer, and chronic obstructive pulmonary disease. Risk associated with cigarette smoking is independent of culture.
From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Drs Jacobs, Adachi, Menotti, and Blackburn); National Institute of Public Health and the Environment (Ms Mulder) and the Department of Chronic Diseases and Environmental Epidemiology, National Institute of Public Health and Environment Protection (Dr Kromhout), Bilthoven, the Netherlands; and the Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland (Dr Nissinen).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
Archives of Internal Medicine Reader's Choice: Continuing Medical Education
Arch Intern Med. 1999;159(7):760-761.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Smoking cessation pharmacotherapy
Frishman
Ther Adv Cardiovasc Dis 2009;3:287-308.
ABSTRACT
Chronic Obstructive Pulmonary Disease with Lung Cancer and/or Cardiovascular Disease
Rodriguez-Roisin and Soriano
Proc Am Thorac Soc 2008;5:842-847.
ABSTRACT
| FULL TEXT
Ten year trends in chronic disease risk factors in the Republic of Karelia, Russia
Vlasoff et al.
Eur J Public Health 2008;18:666-673.
ABSTRACT
| FULL TEXT
Incidence and Risk Factors for Stroke in American Indians: The Strong Heart Study
Zhang et al.
Circulation 2008;118:1577-1584.
ABSTRACT
| FULL TEXT
Cigarette Smoking and Risk of Stroke in the Chinese Adult Population
Kelly et al.
Stroke 2008;39:1688-1693.
ABSTRACT
| FULL TEXT
Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration
Barzi et al.
Tobacco Control 2008;17:166-172.
ABSTRACT
| FULL TEXT
Is weak association between cigarette smoking and cardiovascular disease mortality observed in Japan explained by low total cholesterol? NIPPON DATA80
Hozawa et al.
Int J Epidemiol 2007;36:1060-1067.
ABSTRACT
| FULL TEXT
Mortality and life expectancy in relation to long-term cigarette, cigar and pipe smoking: The Zutphen Study
Streppel et al.
Tobacco Control 2007;16:107-113.
ABSTRACT
| FULL TEXT
Smoking behaviour in European patients with established coronary heart disease
Scholte op Reimer et al.
Eur Heart J 2006;27:35-41.
ABSTRACT
| FULL TEXT
Favorable Cardiovascular Risk Profile in Middle Age and Health-Related Quality of Life in Older Age
Daviglus et al.
Arch Intern Med 2003;163:2460-2468.
ABSTRACT
| FULL TEXT
PET Studies of the Influences of Nicotine on Neural Systems in Cigarette Smokers
Rose et al.
Am. J. Psychiatry 2003;160:323-333.
ABSTRACT
| FULL TEXT
Smoking Reduction, Smoking Cessation, and Mortality: A 16-year Follow-up of 19,732 Men and Women from the Copenhagen Centre for Prospective Population Studies
Godtfredsen et al.
Am J Epidemiol 2002;156:994-1001.
ABSTRACT
| FULL TEXT
Health status measured with the CRQ does not predict mortality in COPD
Oga et al.
Eur Respir J 2002;20:1147-1151.
ABSTRACT
| FULL TEXT
With recent changes in environmental factors among Africans in South Africa, how have cancer occurrences been affected?
Walker
The Journal of the Royal Society for the Promotion of Health 2002;122:148-155.
ABSTRACT
Dyspnea Is a Better Predictor of 5-Year Survival Than Airway Obstruction in Patients With COPD*
Nishimura et al.
Chest 2002;121:1434-1440.
ABSTRACT
| FULL TEXT
Smoking cessation, decline in pulmonary function and total mortality: a 30 year follow up study among the Finnish cohorts of the Seven Countries Study
Pelkonen et al.
Thorax 2001;56:703-707.
ABSTRACT
| FULL TEXT
Elevated White Blood Cell Count and Carotid Plaque Thickness : The Northern Manhattan Stroke Study
Elkind et al.
Stroke 2001;32:842-849.
ABSTRACT
| FULL TEXT
Helping Our Clients With Smoking Cessation
Cataldo and Talley
J Am Psychiatr Nurses Assoc 2001;7:26-31.
Perioperative Ventilation of the Vascular Surgery Patient
Tung
SEMIN CARDIOTHORAC VASC ANESTH 2000;4:265-274.
ABSTRACT
Pulmonary function, smoking cessation and 30 year mortality in middle aged Finnish men
Pelkonen et al.
Thorax 2000;55:746-750.
ABSTRACT
| FULL TEXT
Saturated fat, vitamin C and smoking predict long-term population all-cause mortality rates in the Seven Countries Study
Kromhout et al.
Int J Epidemiol 2000;29:260-265.
ABSTRACT
| FULL TEXT
Benzo[a]pyrene Induces the Transcription of Cyclooxygenase-2 in Vascular Smooth Muscle Cells. EVIDENCE FOR THE INVOLVEMENT OF EXTRACELLULAR SIGNAL-REGULATED KINASE AND NF-kappa B
Yan et al.
J. Biol. Chem. 2000;275:4949-4955.
ABSTRACT
| FULL TEXT
|
