Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

English version České info

Background:
Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.

Methods and Findings:
We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.

Conclusions:
Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.

Please see later in the article for the Editors' Summary

Vyšlo v časopise: Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts. PLoS Med 11(4): e32767. doi:10.1371/journal.pmed.1001631
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pmed.1001631

Souhrn

Zdroje

1. US Department of Health and Human Services (1989) Reducing the health consequences of smoking: 25 years of progress. A report of the Surgeon General. DHHS Publication No. CDC 89–8411. Rockville (Maryland): US Department of Health and Human Services.

2. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2004) Tobacco smoke and involuntary smoking. IARC Monogr Eval Carcinog Risks Hum 8: 1–1438.

3. JhaP (2009) Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer 9: 655–664.

4. Forey B, Hamling J, Lee P, Wald N, editors (2009) International smoking statistics: a collection of historical data from 30 economically developed countries. New York: Oxford University Press.

5. PirieK, PetoR, ReevesGK, GreenJ, BeralV, et al. (2013) The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet 381: 133–141.

6. PetoR, LopezAD, BorehamJ, ThunM, HeathCJr (1992) Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet 339: 1268–1278.

7. EzzatiM, LopezAD (2003) Estimates of global mortality attributable to smoking in 2000. Lancet 362: 847–852.

8. Peto R, Lopez AD, Boreham J, Thun M (2012) Mortality from smoking in developed countries, 1950–2005 (or later). Oxford: University of Oxford Clinical Trial Service Unit. Available: http://www.ctsu.ox.ac.uk/~tobacco/. Accessed 18 Mar 2014.

9. ThunMJ, CarterBD, FeskanichD, FreedmanND, PrenticeR, et al. (2013) 50-year trends in smoking-related mortality in the United States. N Engl J Med 368: 351–364.

10. JhaP, RamasundarahettigeC, LandsmanV, RostronB, ThunM, et al. (2013) 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med 368: 341–350.

11. MolariusA, ParsonsRW, DobsonAJ, EvansA, FortmannSP, et al. (2001) WHO MONICA Project. Trends in cigarette smoking in 36 populations from the early 1980s to the mid-1990s: findings from the WHO MONICA Project. Am J Public Health 91: 206–212.

12. GiovinoGA, MirzaSA, SametJM, GuptaPC, JarvisMJ, et al. (2012) Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys. Lancet 380: 668–679.

13. Chan M (2008) WHO report on the global tobacco epidemic 2008. Geneva: World Health Organization.

14. GuD, KellyTN, WuX, ChenJ, SametJM, et al. (2009) Mortality attributable to smoking in China. N Engl J Med 360: 150–159.

15. ChenZM, XuZ, CollinsR, LiWX, PetoR (2007) Early health effects of the emerging tobacco epidemic in China. A 16-year prospective study. JAMA 278: 1500–1504.

16. LiuBQ, PetoR, ChenZM, BorehamJ, WuYP, et al. (1998) Emerging tobacco hazards in China: 1. retrospective proportional mortality study of one million deaths. BMJ 317: 1411–1422.

17. JhaP, JacobB, GajalakshmiV, GuptaPC, DhingraN, et al. (2008) A nationally representative case-control study of smoking and death in India. N Engl J Med 58: 1137–1147.

18. LamTH, HoSY, HedleyAJ, MakKH, PetoR (2001) Mortality and smoking in Hong Kong: case-control study of all adult deaths in 1998. BMJ 323: 361.

19. LiawKM, ChenCJ (1998) Mortality attributable to cigarette smoking in Taiwan: a 12-year follow-up study. Tob Control 7: 141–148.

20. KatanodaK, MarugameT, SaikaK, SatohH, TajimaK, et al. (2008) Population attributable fraction of mortality associated with tobacco smoking in Japan: a pooled analysis of three large-scale cohort studies. J Epidemiol 18: 251–264.

21. MurakamiY, MiuraK, OkamuraT, UeshimaH (2011) EPOCH-JAPAN Research Group (2011) Population attributable numbers and fractions of deaths due to smoking: a pooled analysis of 180,000 Japanese. Prev Med 52: 60–65.

22. Mathers C, Boerma JT, Fat DM, World Health Organization (2008) The global burden of disease: 2004 update. Geneva: World Health Organization.

23. ZhengW, McLerranDF, RollandB, ZhangX, InoueM, et al. (2011) Association between body-mass index and risk of death in more than 1 million Asians. N Engl J Med 364: 719–729.

24. BrockwellSE, GordonIR (2001) A comparison of statistical methods for meta-analysis. Stat Med 20: 825–840.

25. DerSimonianR, LairdN (1986) Meta-analysis in clinical trials. Control Clin Trials 7: 177–188.

26. DollR, PetoR, WheatleyK, GrayR, SutherlandI (1994) Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ 309: 901–911.

27. SakataR, McGaleP, GrantEJ, OzasaK, PetoR, et al. (2012) Impact of smoking on mortality and life expectancy in Japanese smokers: a prospective cohort study. BMJ 345: e7093.

28. WhincupPH, GilgJA, EmbersonJR, JarvisMJ, FeyerabendC, et al. (2004) Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement. BMJ 329: 200–205.

29. ObergM, JaakkolaMS, WoodwardA, PerugaA, Prüss-UstünA (2011) Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 377: 139–146.

30. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2007) Smokeless tobacco and some tobacco-specific N-nitrosamines. IARC Monogr Eval Carcinog Risks Hum 89: 1–592.

31. Thun MJ, Heenley SJ (2006) Tobacco. In: Schottenfeld F, Fraumeni JF Jr, editors. Cancer epidemiology and prevention. New York: Oxford University Press. pp. 217–242.

32. MathersCD, LoncarD (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3: e442.

33. World Health Organization (2003) WHO Framework Convention on Tobacco Control. Geneva: World Health Organization.

34. JeeSH, SullJW, ParkJ, LeeSY, OhrrH, et al. (2006) Body-mass index and mortality in Korean men and women. N Engl J Med 355: 779–787.