Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay cohort study
Tobacco associated mortality in Mumbai (Bombay) India. Results of the Bombay cohort study
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DOI：
10.1093/ije/dyi196
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发表时间：
2005-12-01
影响因子：
7.7
通讯作者：
Sankaranarayanan, R
中科院分区：
文献类型：
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作者：
Gupta, PC;Pednekar, MS;Sankaranarayanan, R
背景对于印度广泛流行的吸烟以外的烟草使用形式造成的死亡率过高的情况知之甚少，例如双向吸烟和各种形式的无烟烟草使用。我们报告了印度孟买市不同类型吸烟者与从不吸烟者死亡的绝对和相对风险。方法以孟买选民名单为选择框架，在1992-94年间对99570名年龄=35岁的人进行了家访。在5.5年后的积极随访中(1997-99)，追踪到97244例(97.7%)。其中有7531例死亡(男性4119例，女性3412例)，其中89%在研究区域内死亡。可以从市政公司的记录中提取5470例死亡的死因信息。结果调整后的相对危险度分别为1.37(95%CI 1.23~1.53)和1.64(95%CI 1.47~1.81)，与吸烟人数或吸烟人数呈剂量-反应关系。女性基本上是无烟烟草使用者；调整后的相对风险为1.25(95%可信区间为1.15-1.35)。男性吸烟者死于呼吸系统疾病(RR 2.12，95%CI 1.57~2.87)、肺结核(RR 2.30，95%CI 1.68~3.15)和肿瘤(RR 2.60，95%CI 1.78~3.80)的风险显著高于从不吸烟者。
Background Little is known about the excess mortality from forms of tobacco use other than cigarette smoking that are widely prevalent in India, such as bidi smoking and the various forms of smokeless tobacco use. We report on absolute and relative risks of mortality among various kinds of ever tobacco users vs never-users in the city of Mumbai, India.Methods Using the Mumbai voters' list as the selection frame, 99 570 individuals aged >= 35 years were interviewed at their homes during 1992-94. At active follow-up (during 1997-99) after 5.5 years, 97 244 (97.7%) were traced. Among these, 7531 deaths (4119 men, 3412 women) were recorded, of which 89% died within study area. It was possible to abstract cause of death information from the records of the municipal corporation for 5470 deaths. These were coded using ICD 10.Results The adjusted relative risk was 1.37 (95% CI 1.23-1.53) for (men) cigarette smokers and 1.64 (95% CI 1.47-1.81) for bidi smokers, with a significant dose-response relationship for number of bidis or cigarettes smoked. Women were essentially smokeless tobacco users; the adjusted relative risk was 1.25 (95% CI 1.15-1.35). The risk of deaths from respiratory diseases (RR 2.12, 95% CI 1.57-2.87), tuberculosis (RR 2.30, 95% CI 1.68-3.15), and neoplasms (RR 2.60, 95% CI 1.78-3.80) were significantly high in male smokers than never tobacco users.Conclusions Bidi is no less hazardous than cigarette smoking, and smokeless tobacco use may also result in significantly increased mortality.