Does Smoking Reduction in Midlife Reduce Mortality Risk? Results of 2 Long-Term Prospective Cohort Studies of Men and Women in Scotland
Open Access
- 3 July 2013
- journal article
- research article
- Published by Oxford University Press (OUP) in American Journal of Epidemiology
- Vol. 178 (5), 770-779
- https://doi.org/10.1093/aje/kwt038
Abstract
A long-term cohort study of working men in Israel found that smokers who reduced their cigarette consumption had lower subsequent mortality rates than those who did not. We conducted comparable analyses in 2 populations of smokers in Scotland. The Collaborative Study included 1,524 men and women aged 40–65 years in a working population who were screened twice, in 1970–1973 and 1977. The Renfrew/Paisley Study included 3,730 men and women aged 45–64 years in a general population who were screened twice, in 1972–1976 and 1977–1979. Both groups were followed up through 2010. Subjects were categorized by smoking intensity at each screening as smoking 0, 1–10, 11–20, or ≥21 cigarettes per day. At the second screening, subjects were categorized as having increased, maintained, or reduced their smoking intensity or as having quit smoking between the first and second screenings. There was no evidence of lower mortality in all reducers compared with maintainers. Multivariate adjusted hazard ratios of mortality were 0.91 (95% confidence interval (CI): 0.75, 1.10) in the Collaborative Study and 1.08 (95% CI: 0.97, 1.20) in the Renfrew/Paisley Study. There was clear evidence of lower mortality among quitters in both the Collaborative Study (hazard ratio = 0.66, 95% CI: 0.56, 0.78) and the Renfrew/Paisley Study (hazard ratio = 0.75, 95% CI: 0.67, 0.84). In the Collaborative Study only, we observed lower mortality similar to that of quitters among heavy smokers (≥21 cigarettes/day) who reduced their smoking intensity. These inconclusive results support the view that reducing cigarette consumption should not be promoted as a means of reducing mortality, although it may have a valuable role as a step toward smoking cessation.Keywords
This publication has 20 references indexed in Scilit:
- The Use of Nicotine Replacement Therapy for Smoking Reduction and Temporary Abstinence: An Interview StudyNicotine & Tobacco Research, 2012
- Obesity, overweight and liver disease in the Midspan prospective cohort studiesInternational Journal of Obesity, 2010
- Risk of Stroke and Myocardial Infarction After Reduction or Cessation of Cigarette SmokingStroke, 2008
- Health consequences of reduced daily cigarette consumptionTobacco Control, 2006
- The Midspan studiesInternational Journal of Epidemiology, 2005
- Smoking reduction, smoking cessation, and incidence of fatal and non-fatal myocardial infarction in Denmark 1976-1998: a pooled cohort studyJournal of Epidemiology and Community Health, 2003
- Two behavioral treatments for smoking reduction: a pilot studyNicotine & Tobacco Research, 2001
- Reduced smoking: an introduction and review of the evidenceAddiction, 2000
- A Proportional Hazards Model for the Subdistribution of a Competing RiskJournal of the American Statistical Association, 1999
- Education and occupational social class: which is the more important indicator of mortality risk?Journal of Epidemiology and Community Health, 1998