Cigarette Smoking and All-Cause and Cause-Specific Adult Mortality in the United States.
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SUBMITTER: Lariscy JT
PROVIDER: S-EPMC6219821 | biostudies-literature | 2018 Oct
REPOSITORIES: biostudies-literature
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Project description:BackgroundFrailty is a common condition among older adults increasing risk of adverse outcomes including mortality; however, little is known about the incidence or risk of specific causes of death among frail individuals.MethodsData came from the Health and Retirement Study (HRS; 2004-2012), linked to underlying cause-of-death information from the National Death Index (NDI). Community-dwelling HRS participants aged 65 and older who completed a general health interview and physical measurements (n = 10,490) were included in analysis. Frailty was measured using phenotypic model criteria-exhaustion, low weight, low energy expenditure, slow gait, and weakness. Underlying causes of death were determined using International Classification of Diseases, Version 10 codes. We used Cox proportional hazards and competing risks regression models to calculate and compare incidence of cause-specific mortality by frailty status.ResultsDuring follow-up, prefrail and frail older adults had significantly greater hazard of all-cause mortality compared to individuals without symptoms (adjusted hazard ratio [HR] prefrail: 1.85, 95% CI: 1.51, 2.25; HR frail: 2.75, 95% CI: 2.14, 3.53). Frailty was associated with 2.96 (95% CI: 2.17, 4.03), 2.82 (95% CI: 2.02, 3.94), 3.48 (95% CI: 2.17, 5.59), and 2.87 (95% CI: 1.47, 5.59) times greater hazard of death from heart disease, cancer, respiratory illness, and dementia, respectively.ConclusionsSignificantly greater risk of mortality from several different causes should be considered alongside the potential costs of screening and intervention for frailty in subspecialty and general geriatric clinical practice. Findings may help investigators estimate the potential impact of frailty reduction approaches on mortality.
| S-EPMC7518553 | biostudies-literature
Project description:Very few studies have examined the association between light cigarette smoking (i.e., ?5 cigarettes per day) and mortality. The aim of this study was to examine the association of light cigarette smoking with all-cause and cause-specific mortality among adults in the United States. Data were from 13 waves of the National Health Interview Survey (1997 to 2009) that were linked to the National Death Index records through December 31, 2011. A total of 329,035 participants aged ?18 years in the United States were included. Deaths were from all cause, cancer, cardiovascular disease (CVD) and respiratory disease and were confirmed by death certification. During a median follow-up of 8.2 years, 34,862 participants died, of which 8415 were from cancer, 9031 from CVD, and 2040 from respiratory disease. Compared with never-smokers, participants who smoked 1-2 (hazard ratios (HR) = 1.94, 95%CI = 1.73-2.16) and 3-5 cigarettes (HR = 1.99, 1.83-2.17) per day were at higher risk of all-cause mortality after adjustment for demographic variables, lifestyle factors and physician-diagnosis of chronic disease. The associations were stronger for respiratory disease-specific mortality, followed by cancer-specific mortality and CVD-specific mortality. For example, the HRs (95% CIs) of smoking 1-2 cigarettes per day were 9.75 (6.15-15.46), 2.28 (1.84-2.84) and 1.93 (1.58-2.36), respectively, for these three cause-specific mortalities. This study indicates that light cigarette smoking increases risk of all-cause and cause-specific mortality in US adults.
| S-EPMC7399798 | biostudies-literature
Project description:Importance:Ambient fine particulate matter (PM2.5) air pollution is associated with increased risk of several causes of death. However, epidemiologic evidence suggests that current knowledge does not comprehensively capture all causes of death associated with PM2.5 exposure. Objective:To systematically identify causes of death associated with PM2.5 pollution and estimate the burden of death for each cause in the United States. Design, Setting, and Participants:In a cohort study of US veterans followed up between 2006 and 2016, ensemble modeling was used to identify and characterize morphology of the association between PM2.5 and causes of death. Burden of death associated with PM2.5 exposure in the contiguous United States and for each state was then estimated by application of estimated risk functions to county-level PM2.5 estimates from the US Environmental Protection Agency and cause-specific death rate data from the Centers for Disease Control and Prevention. Main Outcomes and Measures:Nonlinear exposure-response functions of the association between PM2.5 and causes of death and burden of death associated with PM2.5. Exposures:Annual mean PM2.5 levels. Results:A cohort of 4?522?160 US veterans (4?243?462 [93.8%] male; median [interquartile range] age, 64.1 [55.7-75.5] years; 3?702?942 [82.0%] white, 667?550 [14.8%] black, and 145?593 [3.2%] other race) was followed up for a median (interquartile range) of 10.0 (6.8-10.2) years. In the contiguous United States, PM2.5 exposure was associated with excess burden of death due to cardiovascular disease (56?070.1 deaths [95% uncertainty interval {UI}, 51?940.2-60?318.3 deaths]), cerebrovascular disease (40?466.1 deaths [95% UI, 21?770.1-46?487.9 deaths]), chronic kidney disease (7175.2 deaths [95% UI, 5910.2-8371.9 deaths]), chronic obstructive pulmonary disease (645.7 deaths [95% UI, 300.2-2490.9 deaths]), dementia (19?851.5 deaths [95% UI, 14?420.6-31?621.4 deaths]), type 2 diabetes (501.3 deaths [95% UI, 447.5-561.1 deaths]), hypertension (30?696.9 deaths [95% UI, 27?518.1-33?881.9 deaths]), lung cancer (17?545.3 deaths [95% UI, 15?055.3-20?464.5 deaths]), and pneumonia (8854.9 deaths [95% UI, 7696.2-10?710.6 deaths]). Burden exhibited substantial geographic variation. Estimated burden of death due to nonaccidental causes was 197?905.1 deaths (95% UI, 183?463.3-213?644.9 deaths); mean age-standardized death rates (per 100?000) due to nonaccidental causes were higher among black individuals (55.2 [95% UI, 50.5-60.6]) than nonblack individuals (51.0 [95% UI, 46.4-56.1]) and higher among those living in counties with high (65.3 [95% UI, 56.2-75.4]) vs low (46.1 [95% UI, 42.3-50.4]) socioeconomic deprivation; 99.0% of the burden of death due to nonaccidental causes was associated with PM2.5 levels below standards set by the US Environmental Protection Agency. Conclusions and Relevance:In this study, 9 causes of death were associated with PM2.5 exposure. The burden of death associated with PM2.5 was disproportionally borne by black individuals and socioeconomically disadvantaged communities. Effort toward cleaner air might reduce the burden of PM2.5-associated deaths.
| S-EPMC6902821 | biostudies-literature
Project description:Rationale: Many studies have linked short-term exposure to ozone (O3) with morbidity and mortality, but epidemiologic evidence of associations between long-term O3 exposure and mortality is more limited.Objectives: To investigate associations of long-term (annual or warm season average of daily 8-h maximum concentrations) O3 exposure with all-cause and cause-specific mortality in the NIH-AARP Diet and Health Study, a large prospective cohort of U.S. adults with 17 years of follow-up from 1995 to 2011.Methods: The cohort (n = 548,780) was linked to census tract-level estimates for O3. Associations between long-term O3 exposure (averaged values from 2002 to 2010) and multiple causes of death were evaluated using multivariate Cox proportional hazards models, adjusted for individual- and census tract-level covariates, and potentially confounding copollutants and temperature.Measurements and Main Results: Long-term annual average exposure to O3 was significantly associated with deaths caused by cardiovascular disease (per 10 ppb; hazard ratio [HR], 1.03; 95% confidence interval [CI], 1.01-1.06), ischemic heart disease (HR, 1.06; 95% CI, 1.02-1.09), respiratory disease (HR, 1.04; 95% CI, 1.00-1.09), and chronic obstructive pulmonary disease (HR, 1.09; 95% CI, 1.03-1.15) in single-pollutant models. The results were robust to alternative models and adjustment for copollutants (fine particulate matter and nitrogen dioxide), although some evidence of confounding by temperature was observed. Significantly elevated respiratory disease mortality risk associated with long-term O3 exposure was found among those living in locations with high temperature (Pinteraction < 0.05).Conclusions: This study found that long-term exposure to O3 is associated with increased risk for multiple causes of mortality, suggesting that establishment of annual and/or seasonal federal O3 standards is needed to more adequately protect public health from ambient O3 exposures.
| S-EPMC6794108 | biostudies-literature
Project description:Employers play a vital role in promoting and supporting tobacco use cessation among tobacco-using workers. Cigarette smoking during pregnancy is a preventable cause of complications in pregnancy and adverse infant health outcomes.To estimate cigarette smoking prevalence and attempts to quit among working women of reproductive age in different industries and occupations using a nationally representative survey.The 2009-2013 National Health Interview Survey data for women of reproductive age (18-49 years) who were working in the week prior to the interview (n = 30855) were analyzed. Data were adjusted for nonresponse and weighted to produce nationally representative estimates.During 2009-2013, among working women of reproductive age, an estimated 17.3% (95% confidence interval [CI]: 16.7-17.8) and 12.9% (95% CI: 12.4-13.4) were current and former cigarette smokers, respectively. Of women who smoke daily, 44.5% (95% CI: 42.5-46.5) had made a quit attempt for more than 1 day in the year before the interview. Cigarette smoking prevalence was highest among women working in the construction industry (29.2%; 95% CI: 22.8-35.7) and in construction and extraction occupations (34.6%; 95% CI: 23.4-45.9). Among working women who were pregnant at the time of the interview, 6.8% (95% CI: 4.4-9.2) and 20.4% (95% CI: 16.9-24.0) were current and former cigarette smokers, respectively.Cigarette smoking prevalence varies by industry and occupation. Intensifying tobacco control efforts in high prevalence industries and occupations could result in higher cessation rates and improvements in health among women of reproductive age.This study identified discrepancies in cigarette smoking among women of reproductive age across industries and occupations. In the absence of smoke-free local and state laws, employer-established smoke-free policies and workplace cessation programs are important for achieving reduction of tobacco use among women and for protecting other workers' health. Results in this report may assist in developing educational campaigns targeting women in industries and occupations with high prevalence of cigarette smoking and low percentage of ever-smokers who had quit.
| S-EPMC5301263 | biostudies-literature
Project description:Increasing cigarette taxes has been the cornerstone of tobacco control policy. Recent work has argued that raising cigarette taxes alone may no longer be an effective strategy for lowering smoking rates. We largely confirm these findings but also find that increases in price continue to predict lower smoking participation in most model specifications. We argue that raising cigarette prices via taxation remains an effective public health policy. We discuss the advantages of homogeneous tax environments and minimum price laws for eliminating opportunities for consumers to offset tax increases by searching for lowest taxes.
| S-EPMC7674120 | biostudies-literature
Project description:IntroductionTobacco policies that limit the sale of cigarettes to minors and restrict smoking in public places are important strategies to deter youth from accessing and consuming cigarettes.MethodsWe examined the relationship of youth cigarette smoking status to state-level youth access and clean indoor air laws, controlling for sociodemographic characteristics and cigarette price. Data were analyzed from the 2001 to 2002 U.S. Health Behavior in School-Aged Children survey, a cross-sectional survey conducted with a nationally representative sample of 13,339 students in the United States.ResultsCompared with students living in states with strict regulations, those living in states with no or minimal restrictions, particularly high school students, were more likely to be daily smokers. These effects were somewhat reduced when logistic regressions were adjusted for sociodemographic characteristics and cigarette price, suggesting that higher cigarette prices may discourage youth to access and consume cigarettes independent of other tobacco control measures.DiscussionStrict tobacco control legislation could decrease the potential of youth experimenting with cigarettes or becoming daily smokers. The findings are consistent with the hypothesis that smoking policies, particularly clean indoor air provisions, reduce smoking prevalence among high school students.
| S-EPMC2699932 | biostudies-literature
Project description:The disease risks from cigarette smoking increased in the United States over most of the 20th century, first among male smokers and later among female smokers. Whether these risks have continued to increase during the past 20 years is unclear.We measured temporal trends in mortality across three time periods (1959-1965, 1982-1988, and 2000-2010), comparing absolute and relative risks according to sex and self-reported smoking status in two historical cohort studies and in five pooled contemporary cohort studies, among participants who became 55 years of age or older during follow-up.For women who were current smokers, as compared with women who had never smoked, the relative risks of death from lung cancer were 2.73, 12.65, and 25.66 in the 1960s, 1980s, and contemporary cohorts, respectively; corresponding relative risks for male current smokers, as compared with men who had never smoked, were 12.22, 23.81, and 24.97. In the contemporary cohorts, male and female current smokers also had similar relative risks for death from chronic obstructive pulmonary disease (COPD) (25.61 for men and 22.35 for women), ischemic heart disease (2.50 for men and 2.86 for women), any type of stroke (1.92 for men and 2.10 for women), and all causes combined (2.80 for men and 2.76 for women). Mortality from COPD among male smokers continued to increase in the contemporary cohorts in nearly all the age groups represented in the study and within each stratum of duration and intensity of smoking. Among men 55 to 74 years of age and women 60 to 74 years of age, all-cause mortality was at least three times as high among current smokers as among those who had never smoked. Smoking cessation at any age dramatically reduced death rates.The risk of death from cigarette smoking continues to increase among women and the increased risks are now nearly identical for men and women, as compared with persons who have never smoked. Among men, the risks associated with smoking have plateaued at the high levels seen in the 1980s, except for a continuing, unexplained increase in mortality from COPD.
| S-EPMC3632080 | biostudies-literature
Project description:Rural areas of the United States have a higher smoking prevalence than urban areas. However, no recent studies have rigorously examined potential changes in this disparity over time or whether the disparity can be explained by demographic or psychosocial characteristics associated with smoking. The present study used yearly cross sectional data from the National Survey on Drug Use and Health from 2007 through 2014 to examine cigarette smoking trends in rural versus urban areas of the United States. The analytic sample included 303,311 respondents. Two regression models were built to examine (a) unadjusted rural and urban trends in prevalence of current smoking and (b) whether differences remained after adjusting for demographic and psychosocial characteristics. Results of the unadjusted model showed disparate and diverging cigarette use trends during the 8-year time period. The adjusted model also showed diverging trends, initially with no or small differences that became more pronounced across the 8-year period. We conclude that differences reported in earlier studies may be explained by differences in rural versus urban demographic and psychosocial risk factors, while more recent and growing disparities appear to be related to other factors. These emergent differences may be attributable to policy-level tobacco control and regulatory factors that disproportionately benefit urban areas such as enforcement of regulations around the sale and marketing of tobacco products and treatment availability. Strong federal policies and targeted or tailored interventions may be important to expanding tobacco control and regulatory benefits to vulnerable populations including rural Americans.
| S-EPMC5600673 | biostudies-literature
Project description:The authors assessed the extent to which socioeconomic status (SES) and the personality factors termed the "big 5" (neuroticism, extraversion, openness to experience, agreeableness, conscientiousness) represented confounded or independent risks for all-cause mortality over a 10-year follow-up in the Midlife Development in the United States (MIDUS) cohort between 1995 and 2004. Adjusted for demographics, the 25th versus 75th percentile of SES was associated with an odds ratio of 1.43 (95% confidence interval (CI): 1.11, 1.83). Demographic-adjusted odds ratios for the 75th versus 25th percentile of neuroticism were 1.38 (95% CI: 1.10, 1.73) and 0.63 (95% CI: 0.47, 0.84) for conscientiousness, the latter evaluated at high levels of agreeableness. Modest associations were observed between SES and the big 5. Adjusting each for the other revealed that personality explained roughly 20% of the SES gradient in mortality, while SES explained 8% of personality risk. Portions of SES and personality risk were explained by health behaviors, although some residual risk remained unexplained. Personality appears to explain some between-SES strata differences in mortality risk, as well as some individual risk heterogeneity within SES strata. Findings suggest that both sociostructural inequalities and individual disposition hold public health implications. Future research and prevention aimed at ameliorating SES health disparities may benefit from considering the risk clustering of social disadvantage and dispositional factors.
| S-EPMC2800299 | biostudies-literature