Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration
Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration
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DOI：
10.1136/tc.2007.023457
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发表时间：
2008-06-01
期刊：
影响因子：
5.2
通讯作者：
Woodward, M.
中科院分区：
文献类型：
--
作者：
Barzi, F.;Huxley, R.;Woodward, M.
背景：虽然吸烟的危害和戒烟的好处在西方已经被公认和理解，但吸烟在亚洲男性中仍然很流行。我们调查了亚洲男性和女性吸烟（包括戒烟）与主要死亡原因之间的关系，并与澳大利亚和新西兰人（ANZ）进行了比较。方法：对亚太地区34项队列研究进行综述，涉及512 676人（81%来自亚洲），中位随访时间为6.7年（20804例死亡）。结果：与从不吸烟者相比，目前吸烟者因特定原因和所有原因导致的死亡率系统地更高。总的死亡率和死因特异性死亡率的危险比（HR）比较当前吸烟者与从不吸烟者、已戒烟者与当前吸烟者以及每天吸烟数量，澳新地区高于亚洲地区（p < 0.001）。对于总体死亡率，亚洲男性和女性吸烟与不吸烟的相对危险度（95% CI）分别为1.37（1.23至1.53）和1.33（1.26至1.40）。澳新银行对应的数据分别为1.95（1.81 - 2.09）和1.85（1.69 - 2.02）。澳新地区男性和女性戒烟的HR分别为0.67（0.63 ~ 0.71）和0.66（0.58 ~ 0.74）。戒烟对亚洲男性有显著的益处，忽略前3年随访后的HR为0.88（0.81 - 0.97）。没有证据表明戒烟对亚洲女性有益，她们很少戒烟。结论：考虑到最近吸烟在亚洲的普及，其影响与在澳新银行观察到的效果相当。亚洲迫切需要严格的烟草控制措施和戒烟战略。
Background: Although the dangers of smoking, and the benefits of quitting, are well established and understood in the West, smoking remains popular among Asian men. We investigated the associations between smoking (including ex-smoking) and major causes of mortality in Asian men and women, and compared with Australians and New Zealanders (ANZ).Methods: An overview of 34 cohort studies in the Asia Pacific region involving 512 676 individuals (81% from Asia), followed up for a median of 6.7 years (20 804 deaths).Results: Mortality rates for cause-specific and all causes of mortality were systematically higher for current compared with never smokers. Hazard ratios (HR) for overall and cause-specific mortality comparing current-smokers with never smokers, ex-smokers with current-smokers and comparing numbers of cigarettes smoked per day, were higher for ANZ than Asia (p < 0.001). For overall mortality, the HR (95% CI) comparing current-smoking with not was 1.37 (1.23 to 1.53) and 1.33 (1.26 to 1.40) in Asian men and women respectively. The corresponding figures in ANZ were 1.95 (1.81 to 2.09) and 1.85 (1.69 to 2.02). The HR for quitting in ANZ was 0.67 (0.63 to 0.71) and 0.66 (0.58 to 0.74) in men and women respectively. Quitting smoking had a significant benefit among Asian men, the HR was 0.88 (0.81 to 0.97) after ignoring the first 3 years of follow-up. There was no evidence of benefit for Asian women, for whom ex-smoking is rare.Conclusions: Allowing for the recent uptake of smoking in Asia, its effects are comparable to those observed in ANZ. Stringent tobacco control measures and smoking cessation strategies are urgently required in Asia.