Characterisation of smoking behaviour across the life course and its impact on decline in lung function and all-cause mortality: evidence from a British birth cohort
Characterisation of smoking behaviour across the life course and its impact on decline in lung function and all-cause mortality: evidence from a British birth cohort
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DOI：
10.1136/jech.2007.068312
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发表时间：
2008-12-01
影响因子：
6.3
通讯作者：
Mishra, G. D.
中科院分区：
文献类型：
--
作者：
Clennell, S.;Kuh, D.;Mishra, G. D.
目的：描述吸烟轨迹从青春期早期到中年，并研究这些轨迹对健康和全因mortality.Methods的影响：一个全国性的代表性的出生队列研究，包括3387名男性和女性，自1946年出生在英格兰，苏格兰和威尔士。主要结果的措施是全因死亡率的年龄为60岁和下降率在用力呼气容积在1秒（FEV（1））。结果：18%的样本被归类为终身吸烟者（吸烟者在所有六个波在年龄20，25，31，36，43，53岁），其中90%已开始吸烟的年龄为18岁。到60岁时，所有终身吸烟者中有10%已经死亡。与从不吸烟者相比，他们的死亡率增加了三倍（风险比（HR）3.2，95%置信区间（CI）2.1至4.8）。对于主要吸烟者（6次数据收集中至少有4次吸烟），死亡率仍高于从不吸烟者（HR 1.6，95% CI 1.0至2.5）。主要不吸烟者与从不吸烟者无差异（HR 1.3，95% CI 0.9至2.0）。使用最新的吸烟状况，目前吸烟者的死亡风险是从不吸烟者的两倍多（HR 2.4，95% CI 1.6至3.5）。终身吸烟者和主要吸烟者的肺功能下降率高于从不吸烟者（回归系数分别为218 ml/年，95% CI 222至213; 26，95% CI -10.3至-1.7）。对于目前的吸烟者，下降为8.4毫升/年（95% CI -12.0至-5.0）的速度比从来没有smokers.Conclusions：使用简化的吸烟行为确定的不利影响的强度和分化，突出了从以前的吸烟者，而不仅仅是目前的吸烟状态获得更多的信息终身吸烟行为的优势。
Objectives: To describe smoking trajectories from early adolescence into mid-life and to examine the effects of these trajectories on health and all-cause mortality.Methods: A nationally representative birth cohort study including 3387 men and women followed up since their birth in 1946 in England, Scotland and Wales. The main outcome measure is all-cause mortality by age 60 years and rate of decline in forced expiratory volume in 1 second (FEV(1)).Results: Eighteen per cent of the sample were categorised as lifelong smokers (smokers at all six waves at ages 20, 25, 31, 36, 43, 53 years), of whom 90% had begun smoking by age 18 years. By age 60 years, 10% of all lifelong smokers had died. They had a threefold increase in mortality rate compared with never smokers (hazard ratio (HR) 3.2, 95% confidence interval (CI) 2.1 to 4.8). For predominantly smokers ( smokers for at least four of the six data collections), mortality rate remained higher than never smokers (HR 1.6, 95% CI 1.0 to 2.5).Predominantly non-smokers did not differ from those who never smoked (HR 1.3, 95% CI 0.9 to 2.0). Using the most recent smoking status available, current smokers had more than double the risk of mortality compared with never smokers (HR 2.4, 95% CI 1.6 to 3.5). Lifelong smokers and predominantly smokers had a greater rate of decline in lung function than never smokers (regression coefficients 218 ml/year, 95% CI 222 to 213; 26, 95% CI -10.3 to -1.7 respectively). For current smokers, the decline was 8.4 ml/year (95% CI -12.0 to -5.0) faster than never smokers.Conclusions: The strength and differentiation of adverse effects identified by using simplified smoking behaviours has highlighted the advantages of obtaining further information on lifelong smoking behaviour from former smokers, rather than just current smoking status.