A nationally representative case-control study of smoking and death in India
A nationally representative case-control study of smoking and death in India
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DOI：
10.1056/nejmsa0707719
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发表时间：
2008-03-13
影响因子：
158.5
通讯作者：
Peto, Richard
中科院分区：
文献类型：
--
作者：
Jha, Prabhat;Jacob, Binu;Peto, Richard
背景资料：吸烟对死亡率在industrial.Methods的全国范围内的影响还没有被评估可靠：在一个全国代表性的样本110万家庭，我们比较了33,000名死者妇女和41,000名死者男子（病例）与吸烟的患病率之间的35,000名妇女和43,000名男子（不匹配的对照组）。吸烟者与非吸烟者的死亡风险比进行了调整的年龄，教育水平，和使用的alcohol.Results：约5%的女性对照组和37%的男性对照组之间的年龄为30和69岁的吸烟者。在该年龄组中，吸烟与女性（风险比，2.0; 99%置信区间[CI]，1.8至2.3）和男性（风险比，1.7; 99% CI，1.6至1.8）中任何医学原因导致的死亡风险增加相关。每天吸烟，即使是少量的烟草与死亡率增加有关。与不吸烟者相比，吸烟者的超额死亡主要来自女性（风险比，3.0; 99%CI，2.4 ~ 3.9）和男性（风险比，2.3; 99%CI，2.1 ~ 2.6）的结核病以及呼吸道、血管或肿瘤疾病。吸烟与女性中位生存期减少8年（99%CI，5 - 11）和男性中位生存期减少6年（99%CI，5 - 7）相关。如果这些关联主要是因果关系，那么在30至69岁的人群中，每20名妇女中就有1人死于吸烟，每5名男子中就有1人死于吸烟。2010年，吸烟将导致印度约930，000名成年人死亡;其中约70%（90，000名女性和580，000名男性）将在30至69岁之间。由于人口的增长，在这个年龄组的死亡的绝对数量上升了约3%year.Conclusions：吸烟导致大量和越来越多的过早死亡在印度。
Background: The nationwide effects of smoking on mortality in India have not been assessed reliably.Methods: In a nationally representative sample of 1.1 million homes, we compared the prevalence of smoking among 33,000 deceased women and 41,000 deceased men (case subjects) with the prevalence of smoking among 35,000 living women and 43,000 living men (unmatched control subjects). Mortality risk ratios comparing smokers with nonsmokers were adjusted for age, educational level, and use of alcohol.Results: About 5% of female control subjects and 37% of male control subjects between the ages of 30 and 69 years were smokers. In this age group, smoking was associated with an increased risk of death from any medical cause among both women (risk ratio, 2.0; 99% confidence interval [CI], 1.8 to 2.3) and men (risk ratio, 1.7; 99% CI, 1.6 to 1.8). Daily smoking of even a small amount of tobacco was associated with increased mortality. Excess deaths among smokers, as compared with nonsmokers, were chiefly from tuberculosis among both women (risk ratio, 3.0; 99% CI, 2.4 to 3.9) and men (risk ratio, 2.3; 99% CI, 2.1 to 2.6) and from respiratory, vascular, or neoplastic disease. Smoking was associated with a reduction in median survival of 8 years for women (99% CI, 5 to 11) and 6 years for men (99% CI, 5 to 7). If these associations are mainly causal, smoking in persons between the ages of 30 and 69 years is responsible for about 1 in 20 deaths of women and 1 in 5 deaths of men. In 2010, smoking will cause about 930,000 adult deaths in India; of the dead, about 70% (90,000 women and 580,000 men) will be between the ages of 30 and 69 years. Because of population growth, the absolute number of deaths in this age group is rising by about 3% per year.Conclusions: Smoking causes a large and growing number of premature deaths in India.