A propensity analysis of cigarette smoking and mortality with consideration of the effects of alcohol.
ABSTRACT Although it is well established that cigarette smoking causes excess mortality, the extent of the increased risk has been challenged because self-selection biases and confounding factors may not have been adequately accounted for in prior studies. We therefore performed a propensity analysis on a population-based cohort. A logistic regression model was used to generate a propensity score for current smoking in 6,099 adults (mean age 46 years, 54% men, 36% current smokers) participating in the National Heart Lung and Blood Institute's (NHLBI) Lipid Research Clinic Prevalence Study. During 12 years of follow-up, 513 subjects (8%) died. After adjusting for age, current smoking was strongly associated with death (compared with never and former smokers, relative risk [RR] 2.69, 95% confidence interval [CI] 1.98 to 0.64, p <0.0001 and RR 1.79, 95% CI 1.26 to 2.55, p = 0.001, respectively). After adjusting for a propensity score based on 27 covariates and the covariates themselves, current smoking remained strongly and independently predictive of excessive death risk in smokers compared with never and former smokers (adjusted RR 2.96, 95% CI 2.16 to 4.05, p <0.0001 and adjusted RR 1.87, 95% CI 1.31 to 2.67, p = 0.0006, respectively). Although smokers were more likely to also drink alcohol, an interaction was noted, whereby, after adjustment for propensity score and other covariates, current smoking was associated with a moderately strong increase in mortality among drinkers (adjusted RR 2.00, 95% CI 1.42 to 2.82, p <0.0001), but was also associated with a markedly increased death risk among nondrinkers (adjusted RR 4.74, 95% CI 3.24 to 6.92, p <0.0001). The independent association of smoking with death even after a rigorous propensity analysis argues that it is highly unlikely that the link between smoking and mortality is materially biased or confounded.
SourceAvailable from: Rodrigo Hasbun
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ABSTRACT: Aim To assess tobacco use and some characteristics of tobacco users (including electronic cigarette users) relevant to cardiovascular disease in a representative population sample of the city of Brno. Methods A cross-sectional survey of cardiovascular risk factors was conducted using the methodology of the Czech post-MONICA Study, in the city of Brno, Czech Republic in 2013. This preliminary report of the first 965 randomly selected volunteers (including 512 women) aged 25–64, focuses on tobacco use, its prevalence in different subgroups as well as on the attitudes towards smoke-free policies. Results This preliminary analysis involves 965 individuals with a mean age of 47.3 ± 11.40 years. The prevalence of smoking was 26.7%, with daily tobacco use 23.3%, less than once daily 3.4%; 19.9% of the sample are ex-smokers. A total of 34.0% of the survey population reported exposure to passive smoking. Electronic cigarette use was observed in 3.5% of respondents, more common in men (5.1%) than in women (2.1%; p = 0.020). Concomitant use of electronic cigarettes and smoking was observed in 2.07% of the population. Conclusion The prevalence of tobacco use in the productive-age population of Brno City district is 26.70%, still a high figure.Cor et vasa 04/2014; DOI:10.1016/j.crvasa.2014.02.005
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ABSTRACT: This paper examines types of research questions posed by educational researchers and identifies intervention research as a type of causal question. Next, research designs for answering causal questions are reviewed, paying attention to the application of lesser used designs that may overcome limitations faced when randomized experimental designs are not feasible or appropriate. The role of the designs is discussed as is the role of non-causal research in education. Finally, a graphical organizer to aid in interpreting existing research and planning future research on educational interventions is presented. A design for a sample study to test the effects of a new math program that may be used as a model for participants who may be considering planning their own research is also presented.Current Issues in Education 01/2010; 13(4):2010.