[Show abstract][Hide abstract] ABSTRACT: Cigarette smoking is a prominent risk factor for a wide range of diseases. The current study aimed to evaluate the impact of smoking on deaths from major smoking-related diseases (neoplasms, vascular diseases and respiratory diseases) in Chinese adults by estimating the potential gains in life expectancy (LE) that would accrue from eliminating deaths from these diseases, and to determine the contribution of each disease to the reduction in LE associated with smoking.
Two cohorts of Chinese smokers and non-smokers were constructed from a retrospective national mortality survey that had been conducted in 1989-1991 and included one million all-cause deaths among adults during 1986-1988 in 103 geographical regions. For each cohort, potential gains in LE by eliminating deaths from each major smoking-related disease were estimated. The contributions of each disease to smoking-associated reduction in LE were assessed using the LE decomposition approach.
Among the major smoking-related diseases, it was estimated that elimination of vascular diseases would provide the greatest potential gain in LE (years), regardless of smoking status. The gains for smokers versus non-smokers in populations of urban men, urban women, rural men and rural women aged 35 years were 3.5 vs. 4.3, 3.8 vs. 4.1, 2.4 vs. 3.0, and 2.6 vs. 2.9 years, respectively. Respiratory diseases contributed most to smoking-associated LE reductions in urban women, rural men and rural women of 43.6%, 46.4%, and 62.9%, respectively. In urban men, neoplasms contributed most to smoking-associated LE reduction, their contribution being estimated as 45.8%.
Respiratory disease has the greatest influence on the LE reduction associated with smoking. Thus, smoking prevention could significantly reduce deaths from respiratory disease and improve LE.
BMC Public Health 12/2013; 13(1):1147. · 2.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We assessed the effect of smoking on death from chronic obstructive pulmonary disease (COPD) in China by employing a large population-based, case-spouse control study design using data from a nationwide survey of mortality.
During 1989-1991, a nationwide retrospective survey of mortality was conducted in China. For approximately 1,000,000 adults dying from all causes during 1986-1988, their surviving spouses or other informants provided detailed information about their own as well as the deceased person's smoking history. For this study, 183,393 individuals who died of COPD at age > or = 40 years were taken as cases, while 272,984 sex-matched surviving spouses of subjects who died from any cause were taken as controls.
COPD death rates for smokers were more than twice as high as those of non-smokers, with a dose-response risk pattern, despite the fact that COPD death rates varied widely by region and age. Tobacco accounted for 41.4% of COPD deaths in men, but only 13.5% of those in women, who had a lower rate of smoking.
A case-spouse control study, as an alternative design, is valid and feasible in utilizing information from population-based, retrospective mortality survey data for an analytical epidemiological study of disease etiology.
Journal of the Formosan Medical Association 05/2010; 109(5):369-77. · 1.00 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To provide a more accurate estimate of early smoking-attributable mortality and potential years of life lost using data from a representative study of 103 study areas in China.
Two datasets were employed as follows. Firstly, retrospective national mortality survey data, which included a population of 67 million in 103 study areas, and about 1 million adults who died in 1986-1988; secondly, nationally representative case-control comparative data was extracted from the survey data to measure the effect of smoking on age trends in smoking-attributable mortality. Potential years of life lost, and sex differences in life expectancy in smokers and non-smokers in the total population aged 35 and over were also estimated.
Tobacco caused 11.2% (16.0% of men and 3.7% of women) of total deaths in 1987, and more than two-thirds of these excess deaths occurred between the ages of 50 and 74 years, but only less than 5% excess deaths occurred at ages under 50. Although life expectancies varied with region or sex differences, the years of life lost attributable to smoking was almost the same. Smokers at age 35 lost about 3 years of life expectancy in comparison with never smokers. The study also confirmed that more than 50% of the sex difference in life expectancy was accounted for by smoking.
Fully understanding the consequences of smoking in relation to mortality can clarify its effects on the health and longevity of the entire population.
Tobacco control 09/2009; 19(1):7-12. · 3.85 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China.
A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed.
Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not.
Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.
International journal of medical sciences 01/2009; 6(6):329-37. · 2.07 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine age-related effects of smoking on lung cancer mortality in a large population-based case-control study that was incorporated into a nationwide retrospective survey of mortality in China.
Two data sets were pooled for this analysis: national mortality survey data and data from a nationwide case-control comparison. These pooled data were used to calculate age-specific lung cancer death rates by smoking status and expected years of lost life expectancy for each smoking-associated death.
There was a significant excess of deaths (54% of urban deaths, 51% of rural deaths) at 35 to 69 years of age among male smokers and the average loss of life expectancy per smoking-associated death at these ages was 18.3 years. For women ages 35 to 69 years of age, 29% and 11% excess lung cancer mortality was observed in urban and rural smokers, respectively, with an average loss of life expectancy per smoking-associated death of 21.3 years.
Tobacco smoking was associated with a large number of deaths from lung cancer. Utilizing information from a population-based retrospective mortality survey for conducting an analytic epidemiological study of main determinants of disease is feasible and can generate important results.
Annals of epidemiology 07/2008; 18(6):484-91. · 2.95 Impact Factor