Smoking, quitting and mortality in an elderly cohort of 56 000 Hong Kong Chinese
Smoking, quitting and mortality in an elderly cohort of 56 000 Hong Kong Chinese
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DOI：
10.1136/tc.2006.019505
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发表时间：
2007-06-01
期刊：
影响因子：
5.2
通讯作者：
Leung, Gabriel M.
中科院分区：
文献类型：
--
作者：
Lam, Tai Hing;Li, Zhi Bin;Leung, Gabriel M.
背景：虽然吸烟的危害已得到充分证实，但尚不清楚它们如何延伸到中国人的老年。目的：研究吸烟与香港老年中国男性和女性的全因死亡率和主要原因特异性死亡率的关系。方法：在一项前瞻性队列研究中，调查了 1998 年至 1998 年期间纳入的 56 167 名（18 749 名男性，37 416 名女性）65 岁以上中国人的死亡率。 2000年，香港政府卫生署辖下18间长者健康中心进行了一项研究。结果：平均随访4.1年，54 214名受试者中，有1848名男性和2035名女性死亡（追踪成功率96.5%）。基线时，当前吸烟者（20.3% vs 4.0%）和前吸烟者（40.8% vs 7.9%）中男性多于女性。与从不吸烟者相比，曾经吸烟者和当前吸烟者全因死亡率的调整后 RR（95% CI），男性分别为 1.39（1.23 至 1.56）和 1.75（1.53 至 2.00），女性为 1.43（1.25 至 1.64）和 1.38（1.14 至 1.68）。对于当前吸烟者来说，每日吸食 1-9 支、10-20 支和 > 21 支香烟时，全因死亡率的 RR (95% CI) 分别为 1.59（1.39 至 1.82）、1.72（1.48 至 2.00）和 1.84（1.43 至 2.35）（趋势 p < 0.001）。以前和现在吸烟者所有癌症死亡的 RR（95% CI）分别为 1.49（1.30 至 1.72）和 2.20（1.88 至 2.57），所有心血管死亡的 RR（95% CI）分别为 1.24（1.04 至 1.47）和 1.57（1.28 至 1.94）。戒烟者因各种原因、肺癌、所有癌症、中风和所有心血管疾病而死亡的风险明显低于当前吸烟者。结论：在老年，吸烟仍然是死亡的主要原因，戒烟是有益的。东方人口迅速老龄化，迫切需要戒烟。
Background: Although the harms of smoking are well established, it is unclear how they extend into old age in the Chinese.Aim: To examine the relationship of smoking with all-cause and major cause-specific mortality in elderly Chinese men and women, respectively, in Hong Kong.Methods: Mortality by smoking status was examined in a prospective cohort study of 56 167 (18 749 men, 37 416 women) Chinese aged >= 65 years enrolled from 1998 to 2000 at all the 18 elderly health centres of the Hong Kong Government Department of Health.Results: After a mean follow-up of 4.1 years, 1848 male and 2035 female deaths occured among 54 214 subjects (96.5% successful follow-up). At baseline, more men than women were current smokers (20.3% vs 4.0%) and former smokers (40.8% vs 7.9%). The adjusted RRs (95% CI) for all-cause mortality in former and current smokers, compared with never smokers, were 1.39 (1.23 to 1.56) and 1.75 (1.53 to 2.00) in men and 1.43 (1.25 to 1.64) and 1.38 (1.14 to 1.68) in women, respectively. For current smokers, the RRs (95% CI) for all-cause mortality were 1.59 ( 1.39 to 1.82), 1.72 (1.48 to 2.00) and 1.84 (1.43 to 2.35) for daily consumption of 1-9, 10-20 and > 21 cigarettes, respectively (p for trend < 0.001). RRs (95% CI) were 1.49 (1.30 to 1.72) and 2.20 (1.88 to 2.57) in former and current smokers for all deaths from cancer, and 1.24 (1.04 to 1.47) and 1.57 (1.28 to 1.94) for all cardiovascular deaths, respectively. Quitters had significantly lower risks of death than current smokers from all causes, lung cancer, all cancers, stroke and all cardiovascular diseases.Conclusions: In old age, smoking continues to be a major cause of death, and quitting is beneficial. Smoking cessation is urgently needed in rapidly ageing populations in the East.