Dataset Information

Smoking cessation-associated mortality reduction: A case-control study in Tianjin city, China.

ABSTRACT:

Introduction

Smoking-attributed mortality is increasing steadily in most developing countries. The aim of the study is to assess the reduction in smoking-associated mortality following cessation.

Methods

Death data were collected from 2016 to 2017. Cases were deaths from pre-defined diseases of interest (65298); controls were deaths from pre-defined non-smoking-related diseases (13527). Case versus control odds ratios for ex-smokers versus smokers were calculated by age, sex, marital status and education with standardized logistic regression. These are described as mortality rate ratios (RRs, calculated as odds ratios), with a group-specific confidence interval (CI). The statistical analysis of the data was conducted from June to August 2019.

Results

For deaths from pre-defined non-smoking-related diseases at age 35-59 years, the RRs for quitting smoking 0-4, 5-9 or ?10 years ago and never smoking were 0.66 (95% CI: 0.55-0.78), 0.58 (95% CI: 0.38-0.88), 0.61 (95% CI: 0.45-0.82), and 0.43 (95% CI: 0.39-0.46), respectively. The same trend was found at ages 60-69 years and 70-79 years. Younger age of quitting (25-44 or 45-64 years) appeared to be associated with greater protection among the age groups: RR was 0.55 (95% CI: 0.42-0.74) and 0.67 (95% CI: 0.56-0.79), respectively, at age 35-59 years. Among the patients who died of lung cancer, the strong protective effect can only be observed when the duration of quitting is ?10 years. The effect of smoking cessation on the risk of death from cardiovascular disease can be observed when the duration of quitting is 1-5 years.

Conclusions

Longer durations of smoking cessation are associated with progressively lower mortality rates from the diseases of interest, such as lung cancer and other smoking related cancers. For sustainable monitoring of tobacco-attributed mortality, smoking information over decades, such as smoking duration and quit smoking years, should be recorded during registration of death.

SUBMITTER: Li W

PROVIDER: S-EPMC7934138 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Publications

Smoking cessation-associated mortality reduction: A case-control study in Tianjin city, China.

Li Wei W Xue Xiaodan X Li Dandan D Pan Yi Y Shen Wenda W Wang Dezheng D Jiang Guohong G

Tobacco induced diseases 20210305

<h4>Introduction</h4>Smoking-attributed mortality is increasing steadily in most developing countries. The aim of the study is to assess the reduction in smoking-associated mortality following cessation.<h4>Methods</h4>Death data were collected from 2016 to 2017. Cases were deaths from pre-defined diseases of interest (65298); controls were deaths from pre-defined non-smoking-related diseases (13527). Case versus control odds ratios for ex-smokers versus smokers were calculated by age, sex, mari ...[more]

PMID: 33688316

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Project description:Smoking is associated with an increased risk of total and cause-specific death, but the rate of mortality risk reduction after quitting compared with continuing to smoke is uncertain. There is inadequate or insufficient evidence to infer the presence or absence of a causal relationship between smoking and ovarian cancer and colorectal cancer.To assess the relationship between cigarette smoking and smoking cessation on total and cause-specific mortality in women.Prospective observational study of 104,519 female participants in the Nurses' Health Study with follow-up from 1980 to 2004.Hazard ratios (HRs) for total mortality, further categorized into vascular and respiratory diseases, lung cancer, other cancers, and other causes.A total of 12,483 deaths occurred in this cohort, 4485 (35.9%) among never smokers, 3602 (28.9%) among current smokers, and 4396 (35.2%) among past smokers. Compared with never smokers, current smokers had an increased risk of total mortality (HR, 2.81; 95% confidence interval [CI], 2.68-2.95) and all major cause-specific mortality. The HR for cancers classified by the 2004 surgeon general's report to be smoking-related was 7.25 (95% CI, 6.43-8.18) and 1.58 (95% CI, 1.45-1.73) for other cancers. Compared with never smokers, the HR for colorectal cancer was 1.63 (95% CI, 1.29-2.05) for current smokers and 1.23 (95% CI, 1.02-1.49) for former smokers. A significant association was not observed for ovarian cancer. Significant trends were observed for earlier age at initiation of smoking for total mortality (P = .003), respiratory disease mortality (P = .001), and all smoking-related cancer mortality (P = .001). The excess risk for all-cause mortality decreases to the level of a never smoker 20 years after quitting, with different time frames for risk reduction observed across outcomes. Approximately 64% of deaths among current smokers and 28% of deaths among former smokers were attributable to cigarette smoking.Most of the excess risk of vascular mortality due to smoking in women may be eliminated rapidly upon cessation and within 20 years for lung diseases. Postponing the age of smoking initiation reduces the risk of respiratory disease, lung cancer, and other smoking-related cancer deaths but has little effect on other cause-specific mortality. These data suggest that smoking is associated with an increased risk of colorectal cancer mortality but not ovarian cancer mortality.

Project description:Introduction:Nearly three times as many homeless youth smoke cigarettes in the United States (US) compared to the general population of youth. Few studies have focused on how to help homeless youth quit smoking. As part of a series of studies to develop a smoking cessation intervention for homeless youth, this study aimed to describe methods used in past quit attempts by homeless youth. Methods: Recruited from a drop-in center in the Midwestern US, the analytic sample was comprised of 32 unaccompanied homeless youth aged 14-24 who smoked combustible tobacco at some point in the past week. In-person qualitative interviews were conducted to understand prior quit attempt experiences of homeless youth. Results:Twenty-two youth (69%) were willing to quit smoking in the next 30 days. Most previous quit attempts were unassisted (78%). Participants frequently reported engaging in distracting behaviors (e.g., video games) or thoughts (e.g., remaining positive). Nicotine replacement therapy (NRT) was another popular method (38%), but with mostly negative reactions. While less common, vaping and use of cannabis to substitute cigarettes was reported in a notable faction of youth (28%), primarily 18-24 years of age. Conclusions:Youth are primarily engaging in non-evidence-based strategies to quit smoking. Existing evidence-based treatments are often underutilized or not used according to instructions, and youth who do use evidence-based treatments do not find them useful. Future research should explore effective cessation treatment among homeless youth that can ideally be provided at shelters and drop-in centers. Implications:Existing evidence-based treatments are underutilized by homeless youth in this study. Most homeless youth are willing to quit in the next month and are interested in trying behavioral counseling and monitored use of NRT. Drop-in centers may be an effective location from which to develop and offer targeted smoking cessation interventions for homeless youth.

Project description:INTRODUCTION:The All Causes of Death Surveillance (ACDS) system was used to measure smoking-attributed mortality by inserting questions on smoking on death certificates. Smoking status information of the deceased has been routinely collected in death certificates since 2010. We describe a death registry-based case-control study using smoking and cause-of-death data for the period 2010-15. METHODS:From 2010, three questions about the smoking status of the deceased were inserted in a revised death certificate: 1) Smoking status (current smoker, quit smoking, never smoker); 2) Number of cigarettes per day smoked; and 3) Number of years of smoking. A data-accuracy survey of 1788 telephone interviews of the family of the deceased was also conducted. Smoking habits (current/ex-smoker vs non-smoker) were compared in study cases (persons who died of lung cancer and other diseases known to be caused by smoking) and the controls (never smokers). Multivariate logistic regression analysis was conducted to estimate relative risks, RR (odds ratios) for smoking-attributed mortality, for lung cancer and all causes of death related to smoking, adjusted for 5-year interval age groups, education, marital status, and year of death. RESULTS:During the study period (2010-15), the annual crude death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.5%, 98.6% and 98.6%, respectively. Compared to never smokers, the RR of ever smoking in males was 1.38 (95% CI: 1.33-1.43) for all causes of smoking-related deaths and 3.07 (95% CI: 2.91-3.24) for lung cancer, while in females the values were 1.46 (95% CI: 1.39-1.54) for all causes of smoking-related deaths and 4.07 (95% CI: 3.81-4.35) for lung cancer. The results in Tianjin are in accord with published results from previous studies. CONCLUSIONS:Levels and trends in smoking attributed mortality can be measured at low cost by using the stable, complete and effective ACDS system in Tianjin.

Project description:ImportanceSome cigarette smokers may not be ready to quit immediately but may be willing to reduce cigarette consumption with the goal of quitting.ObjectiveTo determine the efficacy and safety of varenicline for increasing smoking abstinence rates through smoking reduction.Design, setting, and participantsRandomized, double-blind, placebo-controlled, multinational clinical trial with a 24-week treatment period and 28-week follow-up conducted between July 2011 and July 2013 at 61 centers in 10 countries. The 1510 participants were cigarette smokers who were not willing or able to quit smoking within the next month but willing to reduce smoking and make a quit attempt within the next 3 months. Participants were recruited through advertising.InterventionsTwenty-four weeks of varenicline titrated to 1 mg twice daily or placebo with a reduction target of 50% or more in number of cigarettes smoked by 4 weeks, 75% or more by 8 weeks, and a quit attempt by 12 weeks.Main outcomes and measuresPrimary efficacy end point was carbon monoxide-confirmed self-reported abstinence during weeks 15 through 24. Secondary outcomes were carbon monoxide-confirmed self-reported abstinence for weeks 21 through 24 and weeks 21 through 52.ResultsThe varenicline group (n = 760) had significantly higher continuous abstinence rates during weeks 15 through 24 vs the placebo group (n = 750) (32.1% for the varenicline group vs 6.9% for the placebo group; risk difference (RD), 25.2% [95% CI, 21.4%-29.0%]; relative risk (RR), 4.6 [95% CI, 3.5-6.1]). The varenicline group had significantly higher continuous abstinence rates vs the placebo group during weeks 21 through 24 (37.8% for the varenicline group vs 12.5% for the placebo group; RD, 25.2% [95% CI, 21.1%-29.4%]; RR, 3.0 [95% CI, 2.4-3.7]) and weeks 21 through 52 (27.0% for the varenicline group vs 9.9% for the placebo group; RD, 17.1% [95% CI, 13.3%-20.9%]; RR, 2.7 [95% CI, 2.1-3.5]). Serious adverse events occurred in 3.7% of the varenicline group and 2.2% of the placebo group (P = .07).Conclusions and relevanceAmong cigarette smokers not willing or able to quit within the next month but willing to reduce cigarette consumption and make a quit attempt at 3 months, use of varenicline for 24 weeks compared with placebo significantly increased smoking cessation rates at the end of treatment, and also at 1 year. Varenicline offers a treatment option for smokers whose needs are not addressed by clinical guidelines recommending abrupt smoking cessation.Trial registrationclinicaltrials.gov Identifier: NCT01370356.

Project description:ImportanceLung cancer has become a leading cause of death among people living with human immunodeficiency virus (HIV) (PLWH). Over 40% of PLWH in the United States smoke cigarettes; HIV independently increases the risk of lung cancer.ObjectiveTo project cumulative lung cancer mortality by smoking exposure among PLWH in care.DesignUsing a validated microsimulation model of HIV, we applied standard demographic data and recent HIV/AIDS epidemiology statistics with specific details on smoking exposure, combining smoking status (current, former, or never) and intensity (heavy, moderate, or light). We stratified reported mortality rates attributable to lung cancer and other non-AIDS-related causes by smoking exposure and accounted for an HIV-conferred independent risk of lung cancer. Lung cancer mortality risk ratios (vs never smokers) for male and female current moderate smokers were 23.6 and 24.2, respectively, and for those who quit smoking at age 40 years were 4.3 and 4.5. In sensitivity analyses, we accounted for nonadherence to antiretroviral therapy (ART) and for a range of HIV-conferred risks of death from lung cancer and from other non-AIDS-related diseases (eg, cardiovascular disease).Main outcomes and measuresCumulative lung cancer mortality by age 80 years (stratified by sex, age at entry to HIV care, and smoking exposure); total expected lung cancer deaths, accounting for nonadherence to ART.ResultsAmong 40-year-old men with HIV, estimated cumulative lung cancer mortality for heavy, moderate, and light smokers who continued to smoke was 28.9%, 23.0%, and 18.8%, respectively; for those who quit smoking at age 40 years, it was 7.9%, 6.1%, and 4.3%; and for never smokers, it was 1.6%. Among women, the corresponding mortality for current smokers was 27.8%, 20.9%, and 16.6%; for former smokers, it was 7.5%, 5.2%, and 3.7%; and for never smokers, it was 1.2%. ART-adherent individuals who continued to smoke were 6 to 13 times more likely to die from lung cancer than from traditional AIDS-related causes, depending on sex and smoking intensity. Due to greater AIDS-related mortality risks, individuals with incomplete ART adherence had higher overall mortality but lower lung cancer mortality. Applying model projections to the approximately 644 200 PLWH aged 20 to 64 in care in the United States, 59 900 (9.3%) are expected to die from lung cancer if smoking habits do not change.Conclusions and relevanceThose PLWH who adhere to ART but smoke are substantially more likely to die from lung cancer than from AIDS-related causes.

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Project description:OBJECTIVE AND DESIGN:To relate UK national trends since 1950 in smoking, in smoking cessation, and in lung cancer to the contrasting results from two large case-control studies centred around 1950 and 1990. SETTING:United Kingdom. PARTICIPANTS:Hospital patients under 75 years of age with and without lung cancer in 1950 and 1990, plus, in 1990, a matched sample of the local population: 1465 case-control pairs in the 1950 study, and 982 cases plus 3185 controls in the 1990 study. MAIN OUTCOME MEASURES:Smoking prevalence and lung cancer. RESULTS:For men in early middle age in the United Kingdom the prevalence of smoking halved between 1950 and 1990 but the death rate from lung cancer at ages 35-54 fell even more rapidly, indicating some reduction in the risk among continuing smokers. In contrast, women and older men who were still current smokers in 1990 were more likely than those in 1950 to have been persistent cigarette smokers throughout adult life and so had higher lung cancer rates than current smokers in 1950. The cumulative risk of death from lung cancer by age 75 (in the absence of other causes of death) rose from 6% at 1950 rates to 16% at 1990 rates in male cigarette smokers, and from 1% to 10% in female cigarette smokers. Among both men and women in 1990, however, the former smokers had only a fraction of the lung cancer rate of continuing smokers, and this fraction fell steeply with time since stopping. By 1990 cessation had almost halved the number of lung cancers that would have been expected if the former smokers had continued. For men who stopped at ages 60, 50, 40, and 30 the cumulative risks of lung cancer by age 75 were 10%, 6%, 3%, and 2%. CONCLUSIONS:People who stop smoking, even well into middle age, avoid most of their subsequent risk of lung cancer, and stopping before middle age avoids more than 90% of the risk attributable to tobacco. Mortality in the near future and throughout the first half of the 21st century could be substantially reduced by current smokers giving up the habit. In contrast, the extent to which young people henceforth become persistent smokers will affect mortality rates chiefly in the middle or second half of the 21st century.

Dataset Information

Smoking cessation-associated mortality reduction: A case-control study in Tianjin city, China.

Introduction

Methods

Results

Conclusions

Publications

Smoking cessation-associated mortality reduction: A case-control study in Tianjin city, China.

Similar Datasets

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