Display options
Cite
Yang JJ, Yu D, Shu XO, et al. Reduction in total and major cause-specific mortality from tobacco smoking cessation: a pooled analysis of 16 population-based cohort studies in Asia. Int J Epidemiol. 2021;doi: 10.1093/ije/dyab087.
Yang, J. J., Yu, D., Shu, X. O., Wen, W., Rahman, S., Abe, S., Saito, E., Gupta, P. C., He, J., Tsugane, S., Gao, Y. T., Yuan, J. M., Koh, W. P., Sadakane, A., Tomata, Y., Tsuji, I., Sugawara, Y., Matsuo, K., Ahn, Y. O., Park, S. K., Chen, Y., Inoue, M., Kang, D., & Zheng, W. (2021). Reduction in total and major cause-specific mortality from tobacco smoking cessation: a pooled analysis of 16 population-based cohort studies in Asia. International journal of epidemiology, . https://doi.org/10.1093/ije/dyab087
Yang, Jae Jeong, et al. "Reduction in total and major cause-specific mortality from tobacco smoking cessation: a pooled analysis of 16 population-based cohort studies in Asia." International journal of epidemiology vol. (2021). doi: https://doi.org/10.1093/ije/dyab087
Yang JJ, Yu D, Shu XO, Wen W, Rahman S, Abe S, Saito E, Gupta PC, He J, Tsugane S, Gao YT, Yuan JM, Koh WP, Sadakane A, Tomata Y, Tsuji I, Sugawara Y, Matsuo K, Ahn YO, Park SK, Chen Y, Inoue M, Kang D, Zheng W. Reduction in total and major cause-specific mortality from tobacco smoking cessation: a pooled analysis of 16 population-based cohort studies in Asia. Int J Epidemiol. 2021 Feb 05; doi: 10.1093/ije/dyab087. Epub 2021 Feb 05. PMID: 34009320; PMCID: PMC8743132.
Copy Download .nbib Format: NLM
Share it on

Int J Epidemiol. 2021 Feb 05; doi: 10.1093/ije/dyab087. Epub 2021 Feb 05.

Reduction in total and major cause-specific mortality from tobacco smoking cessation: a pooled analysis of 16 population-based cohort studies in Asia.

International journal of epidemiology

Jae Jeong Yang, Danxia Yu, Xiao-Ou Shu, Wanqing Wen, Shafiur Rahman, Sarah Abe, Eiko Saito, Prakash C Gupta, Jiang He, Shoichiro Tsugane, Yu-Tang Gao, Jian-Min Yuan, Woon-Puay Koh, Atsuko Sadakane, Yasutake Tomata, Ichiro Tsuji, Yumi Sugawara, Keitaro Matsuo, Yoon-Ok Ahn, Sue K Park, Yu Chen, Manami Inoue, Daehee Kang, Wei Zheng

Affiliations

  1. Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA.
  2. Department of Global Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
  3. Division of Prevention, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
  4. Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan.
  5. Division of Cancer Statistics and Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.
  6. Healis-Sekhsaria Institute for Public Health, Mahape, Navi Mumbai, India.
  7. Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
  8. State Key Laboratory of Oncogene and Related Genes & Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
  9. Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
  10. Health Services and Systems Research, Duke-NUS Medical School Singapore, Singapore, Republic of Singapore.
  11. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore.
  12. Radiation Effects Research Foundation, Hiroshima, Japan.
  13. Division of Epidemiology, Tohoku University Graduate School of Medicine, Sendai, Japan.
  14. Department of Health Informatics and Public Health, Division of Epidemiology, Tohoku University School of Public Health, Graduate School of Medicine, Miyagi Prefecture, Japan.
  15. Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
  16. Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
  17. Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea.
  18. Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, South Korea.
  19. Cancer Research Institute, Seoul National University, Seoul, South Korea.
  20. Department of Population Health, New York University School of Medicine, New York, NY, USA.

PMID: 34009320 PMCID: PMC8743132 DOI: 10.1093/ije/dyab087

Abstract

BACKGROUND: Little is known about the time course of mortality reduction following smoking cessation in Asians who have smoking behaviours distinct from their Western counterparts. We evaluated the level of reduction in all-cause, cardiovascular disease (CVD) and lung cancer mortality by years since quitting smoking, in Asia.

METHODS: Using Cox regression, we analysed individual participant data (n = 709 151) from 16 prospective cohorts conducted in China, Japan, Korea/Singapore, and India/Bangladesh, separately by cohorts. Cohort-specific hazard ratios (HRs) were combined using a random-effects meta-analysis.

RESULTS: During a mean follow-up of 12.0 years, 108 287 deaths were ascertained-35 658 from CVD and 7546 from lung cancer. Among Asian men, a dose-response relationship of risk reduction in deaths from all causes, CVD and lung cancer was observed with an increase in years after smoking cessation. Compared with never smokers, however, all-cause and CVD mortality among former smokers remained elevated 10-14 years after quitting [multivariable-adjusted HR (95% confidence interval (CI) = 1.25 (1.13-1.37) and 1.20 (1.02-1.41), respectively]. Lung cancer mortality stayed almost 2-fold higher than among never smokers 15-19 years after smoking cessation [1.97 (1.41-2.73)], particularly among former heavy smokers [2.62 (1.71-4.00)]. Women who quitted for ≥5 years retained a significantly elevated mortality from all causes, CVD and lung cancer. Overall patterns of the cessation-mortality associations were similar across countries.

CONCLUSIONS: Our findings suggest that adverse effects of tobacco smoking persist for an extended time period, even for more than two decades, which is beyond the time windows defined in current clinical guidelines for risk assessment of lung cancer and CVD.

© The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Keywords: Asia; Smoking cessation; cardiovascular disease; cohort; lung cancer; mortality

References

  1. Regul Toxicol Pharmacol. 2013 Oct;67(1):13-26 - PubMed
  2. Int J Epidemiol. 2005 Dec;34(6):1395-402 - PubMed
  3. Regul Toxicol Pharmacol. 2014 Mar;68(2):231-9 - PubMed
  4. N Engl J Med. 2013 Jan 24;368(4):341-50 - PubMed
  5. JAMA. 2019 Aug 20;322(7):642-650 - PubMed
  6. Tob Control. 2010 Feb;19(1):50-7 - PubMed
  7. N Engl J Med. 2014 Jan 2;370(1):60-8 - PubMed
  8. Tob Control. 2013 Jul;22(4):235-40 - PubMed
  9. Control Clin Trials. 1986 Sep;7(3):177-88 - PubMed
  10. BMJ. 2015 Apr 20;350:h1551 - PubMed
  11. Tob Control. 2021 May;30(3):328-335 - PubMed
  12. Ann Intern Med. 2014 Mar 4;160(5):330-8 - PubMed
  13. Circulation. 2008 Feb 12;117(6):743-53 - PubMed
  14. BMJ. 2004 Jun 26;328(7455):1519 - PubMed
  15. BMC Cancer. 2012 Sep 03;12:385 - PubMed
  16. Tob Control. 2012 Jul;21(4):416-21 - PubMed
  17. Regul Toxicol Pharmacol. 2012 Oct;64(1):51-67 - PubMed
  18. J Natl Cancer Inst. 2018 Nov 1;110(11):1201-1207 - PubMed
  19. N Engl J Med. 2011 Feb 24;364(8):719-29 - PubMed
  20. Regul Toxicol Pharmacol. 2014 Feb;68(1):85-95 - PubMed
  21. Elife. 2020 Mar 24;9: - PubMed
  22. Lancet. 2017 May 13;389(10082):1885-1906 - PubMed
  23. Stat Med. 2017 Feb 28;36(5):855-875 - PubMed
  24. JAMA. 2008 May 7;299(17):2037-47 - PubMed
  25. PLoS Med. 2014 Apr 22;11(4):e1001631 - PubMed
  26. Lancet. 2013 Jan 12;381(9861):133-41 - PubMed
  27. Lancet. 2015 Oct 10;386(10002):1447-56 - PubMed
  28. Circulation. 2017 Mar 28;135(13):e793-e813 - PubMed
  29. N Engl J Med. 2013 Jan 24;368(4):351-64 - PubMed
  30. JAMA Netw Open. 2019 Mar 1;2(3):e191474 - PubMed
  31. Am J Epidemiol. 2005 Jan 15;161(2):170-9 - PubMed
  32. Lancet. 2018 Nov 10;392(10159):1923-1994 - PubMed
  33. Arch Intern Med. 2011 Nov 28;171(21):1956-9 - PubMed

Publication Types

Grant support