The smoking-mortality association varies over time and by ethnicity in New Zealand
The smoking-mortality association varies over time and by ethnicity in New Zealand
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DOI：
10.1093/ije/dyi139
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发表时间：
2005-10-01
影响因子：
7.7
通讯作者：
Wilson, N
中科院分区：
文献类型：
--
作者：
Hunt, D;Blakely, T;Wilson, N
背景：吸烟与死亡率相关性的强度可能随时间和种族而变化。方法：通过人口普查和死亡率数据的联系，对160万（1981 - 84年）和190万（1996 - 99年）年龄在25 - 74岁的新西兰人进行队列研究。比较目前吸烟者和从不吸烟者，结果1981~1984年和1996~1999年全因死亡率RR从1.59（95% CI 1.53 - 1.66）至2.05（1.97 - 2.14），男性; 1.49（1.42 - 1.56）至2.01（1.91 - 2.12），女性。1996 - 1999年，非太平洋岛屿族裔非毛利人的全因死亡率明显高于毛利人：男子为2.22（2.12 - 2.33），妇女为2.20（2.09 - 2.33），男子为1.51（1.35 - 1.69），妇女为1.45（0.27 - 1.66）。在调整社会经济因素后，这种RR异质性仍然存在，并且与IHD相似。RDs显示出较小的异质性。举例来说，在1996 - 99年度，每10万人中有627名残疾人士毛利人（452 - 802），而毛利人为464（427 - 502）对于男性中的非毛利人非太平洋裔，结论在新西兰，吸烟对死亡率的相对影响随时间和种族的不同而不同。我们预计，这种异质性存在于其他国家，其背景死亡率随时间或社会群体而变化。需要关于这种异质性的信息，包括具体族裔的数据，以准确确定烟草造成的死亡负担。RR估计值的大小应在绝对死亡率和效应测量的背景下解释。
Background The strength of the smoking - mortality association may vary over time and by ethnic group.Methods Cohort studies of 1.6 million ( 1981 - 84) and 1.9 million (1996 - 99) New Zealanders aged 25 - 74 years were formed by the linkage of census and mortality data. Comparing current smokers with never smokers, standardized rate ratios (RRs) and rate differences (RDs) were calculated for all- cause and ischaemic heart disease (IHD) mortality.Results Between 1981 - 84 and 1996 - 99 the all- cause mortality RR increased from 1.59 (95% CI 1.53 - 1.66) to 2.05 (1.97 - 2.14) for men and from 1.49 ( 1.42 - 1.56) to 2.01 (1.91 - 2.12) for women. All- cause RRs were significantly greater among non-Maori non-Pacific than Maori: 2.22 (2.12 - 2.33) compared with 1.51 (1.35 - 1.69) in men and 2.20 ( 2.09 - 2.33) compared with 1.45 in women ( .27 - 1.66), respectively, in 1996 - 99. This RR heterogeneity remained after adjusting for socio- economic factors and was similar for IHD. The RDs demonstrated less heterogeneity. For example, in 1996 - 99 the RDs were 627 per 100 000 (452 - 802) for Maori compared with 464 (427 - 502) for non-Maori non-Pacific among men, and 368 (228 - 509) compared with 340 (311 - 370) among women.Conclusions In New Zealand the relative effect of smoking on mortality differs over time and by ethnicity. We expect that such heterogeneity exists in other countries where the background mortality rates vary over time or between social groups. Information on this heterogeneity, including ethnicity-specific data, is needed to accurately determine the mortality burden owing to tobacco. The size of the RR estimates should be interpreted in the context of absolute mortality and effect measures.