Quantifying the association of low-intensity and late initiation of tobacco smoking with total and cause-specific mortality in Asia
- 1 May 2021
- journal article
- research article
- Published by BMJ in Tobacco Control
- Vol. 30 (3), 328-335
- https://doi.org/10.1136/tobaccocontrol-2019-055412
Abstract
Background Little is known about the health harms associated with low-intensity smoking in Asians who, on average, smoke fewer cigarettes and start smoking at a later age than their Western counterparts. Methods In this pooled analysis of 738 013 Asians from 16 prospective cohorts, we quantified the associations of low-intensity (= 35 years) of smoking with mortality outcomes. HRs and 95% CIs were estimated for each cohort by Cox regression. Cohort-specific HRs were pooled using random-effects meta-analysis. Findings During a mean follow-up of 11.3 years, 92 068 deaths were ascertained. Compared with never smokers, current smokers who consumed twofold risk of lung cancer mortality. Furthermore, current smokers who started smoking after age 35 and smoked <5 cigarettes/day had significantly elevated risks of all-cause (HRs (95% CIs)=1.14 (1.05 to 1.23)), CVD (1.27 (1.08 to 1.49)) and respiratory disease (1.54 (1.17 to 2.01)) mortality. Even smokers who smoked <5 cigarettes/day but quit smoking before the age of 45 years had a 16% elevated risk of all-cause mortality; however, the risk declined further with increasing duration of abstinence. Conclusions Our study showed that smokers who smoked a small number of cigarettes or started smoking later in life also experienced significantly elevated all-cause and major cause-specific mortality but benefited from cessation. There is no safe way to smoke-not smoking is always the best choice.Funding Information
- National Institutes of Health (UM1CA173640, UM1CA182910)
This publication has 28 references indexed in Scilit:
- Non-Daily Cigarette Smokers: Mortality Risks in the U.S.American Journal of Preventive Medicine, 2018
- Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reportsBMJ, 2018
- Current Cigarette Smoking Among Adults - United States, 2016Morbidity and Mortality Weekly Report (MMWR), 2018
- Association between long‐term low‐intensity cigarette smoking and incidence of smoking‐related cancer in the national institutes of health‐AARP cohortInternational Journal of Cancer, 2017
- Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015The Lancet, 2017
- Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysisInternational Journal of Epidemiology, 2015
- Health Effects of Light and Intermittent SmokingCirculation, 2010
- Health consequences of smoking 1-4 cigarettes per dayTobacco Control, 2005
- Importance of light smoking and inhalation habits on risk of myocardial infarction and all cause mortality. A 22 year follow up of 12 149 men and women in The Copenhagen City Heart StudyJournal of Epidemiology and Community Health, 2002
- Coronary heart disease, cancer and mortality in male middle‐aged light smokersJournal of Internal Medicine, 1992