SMOKING CESSATION IN RELATION TO TOTAL MORTALITY-RATES IN WOMEN - A PROSPECTIVE COHORT STUDY
SMOKING CESSATION IN RELATION TO TOTAL MORTALITY-RATES IN WOMEN - A PROSPECTIVE COHORT STUDY
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DOI：
10.7326/0003-4819-119-10-199311150-00005
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发表时间：
1993-11-15
影响因子：
39.2
通讯作者：
SPEIZER, FE
中科院分区：
文献类型：
--
作者：
KAWACHI, I;COLDITZ, GA;SPEIZER, FE
目的：研究中年妇女戒烟与总死亡率之间的时间关系。设计：前瞻性队列研究，随访12年。设置：居住在美国的注册护士。参与者：117 001名女性注册护士，年龄30 - 55岁，无明显冠心病、中风，和癌症（非黑色素瘤皮肤癌除外）。主要结果测量：总死亡率，进一步分类为心血管疾病死亡、癌症死亡和暴力死亡。在137万人年的随访期间，共有2847人死亡（933人为“从不吸烟者”，799人为前吸烟者，1115人为当前吸烟者）。与从不吸烟者相比，目前吸烟者总死亡率的多变量相对风险为1.87（95%CI，1.65至2.13），既往吸烟者为1.29（CI，1.14至1.46）。在15岁之前开始吸烟的参与者的总死亡率（多变量相对风险，3.15; CI，2.16至4.59），心血管疾病死亡率（相对风险，9.94; CI，5.15至19.19）和外伤死亡（相对风险，5.39; CI，1.84至15.78）的风险最高。与持续吸烟者相比，前吸烟者在戒烟后2年内心血管疾病死亡风险降低了24%。戒烟10至14年后，前吸烟者的总死亡率、心血管疾病和总癌症死亡率的超额风险接近从不吸烟者的水平。戒烟的健康益处明显存在，无论年龄在开始和每日吸烟的数量smoked.Conclusions：吸烟的风险，吸烟对总死亡率在前吸烟者减少近从不吸烟者10至14年后停止。
Objective: To examine the temporal relationship between stopping smoking and total mortality rates among middle-aged women.Design: Prospective cohort study with 12 years of follow-up.Setting: Registered nurses residing in the United States.Participants: 117 001 female registered nurses, ages 30 to 55 years, who were free of manifest coronary heart disease, stroke, and cancer (except nonmelanoma skin cancer) in 1976.Main Outcome Measures: Total mortality, further categorized into deaths from cardiovascular diseases, cancers, and violent deaths.Results: A total of 2847 deaths (933 among ''never smokers,'' 799 among former smokers, and 1115 among current smokers) occurred during 1.37 million person-years of follow-up. The multivariate relative risks for total mortality compared with never smokers were 1.87 (95% CI, 1.65 to 2.13) for current smokers and 1.29 (CI, 1.14 to 1.46) for former smokers. Participants who started smoking before the age of 15 years had the highest risks for total mortality (multivariate relative risk, 3.15; CI, 2.16 to 4.59), cardiovascular disease mortality (relative risk, 9.94; Cl, 5.15 to 19.19), and deaths from external causes of injury (relative risk, 5.39; CI, 1.84 to 15.78). Compared with continuing smokers, former smokers had a 24% reduction in risk for cardiovascular disease mortality within 2 years of quitting. The excess risks for total mortality and both cardiovascular disease and total cancer mortality among former smokers approached the level of that for never smokers after 10 to 14 years of abstinence. The health benefits of cessation were clearly present regardless of the age at starting and daily number of cigarettes smoked.Conclusions: The risk of cigarette smoking on total mortality among former smokers decreases nearly to that of never smokers 10 to 14 years after cessation.