The hazards and benefits associated with smoking and smoking cessation in Asia: a meta-analysis of prospective studies

Nakamura, Koshi; Huxley, Rachel R.; Ansary-Moghaddam, Alireza; Woodward, Mark

doi:10.1136/tc.2008.028795

Cited by 50 publications

(39 citation statements)

References 78 publications

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“…In 2001In and 2007, the smoking prevalence among males aged 30 or older was 54%, 48% and 45%, respectively (4%, 3% and 3% among females: the percentage of smokers among Thai females is small because it not acceptable in Thai culture for women to smoke) (National Statistical Office Thailand, 2004;2007;Vathesatogkit, 2012).…”

Section: Introductionmentioning

confidence: 99%

Association between Smoking and Mortality: Khon Kaen Cohort Study, Thailand

Kamsa-ard

Promthet²,

Lewington³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high, at around 50%. The purpose of this study was to determine the relationship between smoking and mortality in a rural Thai community. Materials and Methods: Subjects enrolled into the Khon Kaen cohort study between 1990 and 2001 were followed up for their vital status until 16 th March 2012. The death resource was from the Bureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used to analyse the association between smoking and death, controlling for age, education level and alcohol drinking, and confidence intervals were calculated using the floating risk method. Results: The study recruited 5,962 male subjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely to die than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32-1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there was no increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (handrolled cigarettes) and manufactured tobacco. Conclusion: Mortality from cancer, particularly lung cancer, and from all causes combined is dependent on smoking status among men in rural Thailand, but the relative risks are lower than have been reported from studies in high income countries, where the tobacco epidemic is more established.

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Section: Introductionmentioning

confidence: 99%

Association between Smoking and Mortality: Khon Kaen Cohort Study, Thailand

Kamsa-ard

Promthet²,

Lewington³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…These previous reports provide one possible explanation for our findings of increased medical expenditures of hypertensives with a smoking habit compared with the other three categories. Alternatively, the effect of smoking on cancer and respiratory disease 8,9 might have contributed to the increased medical expenditures among hypertensives with a smoking habit. Our data on the time-related changes of medical expenditures during the follow-up period support these possible explanations, as there was a 232% increment in future expenditures of individuals with both risk factors compared with individuals with neither risk factor.…”

Section: Discussionmentioning

confidence: 99%

“…The mean level of blood pressure is higher in Japan than in Western countries, 17,35,[37][38][39][40][41] despite a substantial decline in blood pressure during the past four decades. 42 In addition, the prevalence of smoking among Japanese men remains much higher compared with men in the West, [8][9][10]17,35,37,41,43 although there has been a trend for a decline in smoking. 42 As a result, approximately 70-80% of Japanese men have hypertension and/or a smoking habit, 16,23 which would directly contribute to as much as 20% of the entire medical expenditures in this population.…”

Section: Discussionmentioning

confidence: 99%

“…34 Therefore, the participants in this study represented approximately 38% of all NHI beneficiaries aged 40-69 years living in this area. The analysis was conducted only for men, because the prevalence of smokers is quite low among Japanese women; [8][9][10]16,23,35 our data showed that current smokers and former smokers accounted for 3.4% (n¼87) and 0.5% (n¼14), respectively, of 2596 female participants. Of the 1939 male participants, 231 were excluded because they were former smokers (n¼229) or there was no information on smoking habit at the baseline survey (n¼2).…”

Section: Study Design and Participantsmentioning

confidence: 93%

“…[4][5][6][7] Hypertension is a major contributor to cardiovascular diseases in the Asia-Pacific region. 3 Furthermore, cigarette smoking, which leads to cardiovascular disease as well as cancer and respiratory disease, [7][8][9][10][11][12] is also a major health burden in the Asia-Pacific region because of its popularity among men; 13 nearly two-thirds of the world's smokers live in 10 countries, and most of them are in that region. 14 Thus, both hypertension and a smoking habit might be more important determinants of human health than other risk factors in the Asia-Pacific region.…”

Section: Introductionmentioning

confidence: 99%

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Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan

et al. 2010

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Hypertension and smoking are major causes of disability and death, especially in the Asia-Pacific region, where there is a high prevalence of a combination of these two risk factors. We attempted to measure the medical expenditures of a Japanese male population with hypertension and/or a smoking habit over a 10-year period of follow-up. A cohort study was conducted that investigated the medical expenditures due to a smoking habit and/or hypertension during the decade of the 1990s using existing data on physical status and medical expenditures. The participants included 1708 community-dwelling Japanese men, aged 40-69 years, who were classified into the following four categories: 'neither smoking habit nor hypertension', 'smoking habit alone', 'hypertension alone' or 'both smoking habit and hypertension.' Hypertension was defined as a systolic blood pressure of X140 mm Hg, a diastolic blood pressure of X90 mm Hg or taking antihypertensive medications. In the study cohort, 24.9% had both a smoking habit and hypertension. During the 10-year follow-up period, participants with a smoking habit alone (18 444 Japanese yen per month), those with hypertension alone (21 252 yen per month) and those with both a smoking habit and hypertension (31 037 yen per month) had increased personal medical expenditures compared with those without a smoking habit and hypertension (17 418 yen per month). Similar differences were observed even after adjustment for other confounding factors (Po0.01). Japanese men with both a smoking habit and hypertension incurred higher medical expenditures compared with those without a smoking habit, hypertension or their combination.

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Should we consider gallbladder cancer a new smoking‐related cancer? A comprehensive meta‐analysis focused on dose–response relationships

Lugo

Peveri

Gallus

2019

Intl Journal of Cancer

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The few studies on the association of smoking with gallbladder cancer risk have given conflicting results. Here, we provide the most accurate and up-to-date quantification of the effect of cigarette smoking on gallbladder cancer risk, and investigate for the first time the dose-response relationships. Using an innovative approach for the identification of publications, we conducted a systematic review and meta-analysis of epidemiological studies published until March 2019 on the association of smoking with gallbladder cancer risk. Pooled relative risks (RRs) for smoking were estimated using random-effects models; one-stage randomeffects log-linear models were used for dose-response relationships. Out of 22 eligible articles, 20 (11 case-control and 9 cohort studies) were included in the meta-analysis, for a total of 4,676 gallbladder cancer cases. Compared to never smokers, the pooled RR was 1.33 (95% confidence interval [CI]: 1.17-1.51) for current and 1.07 (95% CI: 0.94-1.23) for former smokers. The risk of gallbladder cancer increased linearly with smoking intensity and duration, the RR being 1.60 (95% CI: 1.21-2.11) for 30 cigarettes/day and 1.25 (95% CI: 1.01-1.56) for 30 years of smoking. There was a nonsignificant linear decrease in gallbladder cancer risk with increasing time since quitting, compared to current smokers. Former smokers reached the risk of those who had never smoked 20 years after quitting. This comprehensive meta-analysis suggests a moderately but significantly higher risk of gallbladder cancer for current but not former smokers. We also provide the first report of a linear increase in gallbladder cancer risk according to smoking intensity and duration.Additional Supporting Information may be found in the online version of this article.

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The hazards and benefits associated with smoking and smoking cessation in Asia: a meta-analysis of prospective studies

Cited by 50 publications

References 78 publications

Association between Smoking and Mortality: Khon Kaen Cohort Study, Thailand

Association between Smoking and Mortality: Khon Kaen Cohort Study, Thailand

Medical expenditures of men with hypertension and/or a smoking habit: a 10-year follow-up study of National Health Insurance in Shiga, Japan

Should we consider gallbladder cancer a new smoking‐related cancer? A comprehensive meta‐analysis focused on dose–response relationships

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