Smoking and Risk of All-cause Mortality: The Jichi Medical School (JMS) Cohort Study

Abstract

BACKGROUND: There have been comparatively few large-scale cohort studies analyzing all-cause mortality due to cigarette smoking. The goal of this analysis is to investigate the relationship between smoking status and all-cause mortality, and to evaluate the effect of smoking in the Japanese. METHODS: The baseline data were collected between 1992 and 1995. Ultimately, 10,873 Japanese (4,280 males and 6,593 females) aged 19 years or older from 12 rural communities located across Japan participated in the study. This analysis is based on the results, including the information on those who died and moved out of the communities, obtained by December 31, 2001. The Cox’s proportional hazards model was used to calculate the hazard ratio (HR) of mortality for smoking with adjustment for age, systolic blood pressure, total cholesterol, body mass index, alcohol drinking habit and education. RESULTS: The mean follow-up period was 8.2 years, during which time, 284 males and 192 females died. The multivariate-adjusted HRs for total mortality among former and current smokers compared with never smokers were 1.09 (95% confidence interval [CI]: 0.73-1.61) and 1.65 (95% CI: 1.16-2.35) in males, and 0.98 (95% CI: 0.40-2.42) and 0.91 (95% CI: 0.42-1.95) in females, respectively. Those for the consumption of 1-14, 15-24, and 25+ cigarettes per day among male smokers were 1.62, 1.57, and 1.89, respectively. In females, there was no great difference in all-cause mortality between smokers and never smokers. CONCLUSIONS: The results of our study confirm an increased risk in males of premature death from all causes among Japanese with a smoking habit.

Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration

“…Current smokers in ANZ had twice the risk compared with never smokers, whereas in Asia, current smokers had a one-third higher risk. The magnitude of these estimates, as well as the smaller observed effect among Asian cohorts, are consistent with previous findings from studies conducted in Australia,10 New Zealand11 and Europe1 12 – 14 China,15 – 18 Taiwan,19 20 Japan21 – 23 and Korea 24…”

Joint Impact of Smoking and Hypertension on Cardiovascular Disease and All-Cause Mortality in Japan: NIPPON DATA80, a 19-Year Follow-Up

“…These values were similar to those of Iso et al (10), who found that 23.5% and 6.0% of CVD mortality could be explained by smoking status. Other Japanese studies have also reported similar values for the PAF for all-cause mortality (18)(19)(20) due to smoking (range of PAF: 22-34% for men and 0-5% for women), and other Asian studies have yielded PAFs that are comparable to those in Japan (8).…”

Mortality attributable to cigarette smoking in a cohort study in Japan

“…Despite its importance as a measure in the implementation of disease prevention programs and health policies, few studies to date have assessed PAR. A cohort study in Japan [5] reported 24.9% of male deaths due to all causes. The results from a cohort in Taiwan [7] showed a PAR% of 13.9% for all causes of death, 59.3% for lung cancer, and 30.2% for ischemic heart disease.…”

“…Relative risk is a measure of the strength of an association, and is an indicator used to assess the possibility of a causal relationship. In contrast, relatively few studies use population attributable risk (PAR) [5][6][7], an important measurement of public health impact and health policy decision making.…”