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Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

Journal Article · · PLoS Medicine
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  1. Vanderbilt University, Nashville, TN (United States); Vanderbilt Univ., Nashville, TN (United States)
  2. Fred Hutchinson Cancer Research Center, Seattle, WA (United States)
  3. Vanderbilt University, Nashville, TN (United States); Wuhan University (China)
  4. Icahn School of Medicine at Mount Sinai, New York, NY (United States); International Prevention Research Institute, Lyon (France)
  5. Tulane University, New Orleans, LA (United States)
  6. Healis-Sekhsaria Institute for Public Health, Navi Mumbai (India)
  7. Regional Cancer Center, Trivandrum (India)
  8. National Cancer Center, Tokyo (Japan)
  9. Ibaraki Prefectural Government, Ibaraki (Japan)
  10. Aichi Medical University School of Medicine, Aichi (Japan)
  11. Shanghai Cancer Institute, Shanghai (China)
  12. Duke–National University of Singapore Graduate Medical School (Singapore); National University of Singapore (Singapore)
  13. Vanderbilt University, Nashville, TN (United States)
  14. Radiation Effects Research Foundation, Hiroshima (Japan)
  15. Miyagi Cancer Center Research Institute, Natori (Japan)
  16. Tohoku University, Sendai (Japan)
  17. Aichi Cancer Center Research Institute, Nagoya (Japan)
  18. Genomics Research Center, Academia Sinica, Taipei (Taiwan); National Taiwan University, Taipei (Taiwan)
  19. University of Pittsburgh, PA (United States)
  20. Seoul National University (Korea, Republic of)
  21. University of Chicago, IL (United States)
  22. National Taiwan University, Taipei (Taiwan); Institute of Biomedical Sciences, Academia Sinica, Taipei (Taiwan)
  23. Chinese Academy of Medical Sciences, Beijing (China)
  24. Chinese Academy of Medical Sciences, Beijing (China); China National Center for Cardiovascular Disease, Beijing (China)
  25. International Agency for Research on Cancer, Lyon (France)
  26. Dokkyo Medical University School of Medicine, Tochigi (Japan)
  27. Tohoku University Graduate School of Medicine, Sendai (Japan)
  28. Nagoya City University Graduate School of Medical Science, Nagoya (Japan)
  29. Genomics Research Center, Academia Sinica, Taipei (Taiwan)
  30. Hallym University College of Medicine, Okcheon-dong (Korea, Republic of)
  31. Seoul National University, Seoul (Korea, Republic of)
  32. Columbia University, New York, NY (United States)
  33. National Health Research Institutes, Miaoli (Taiwan)
  34. Institute of Biomedical Sciences, Academia Sinica, Taipei (Taiwan); China Medical University, Taichung (Taiwan)
  35. New York University, New York, NY (United States). School of Medicine
  36. Sookmyung Women’s University, Seoul (Korea, Republic of)
  37. National Institutes of Health (NIH), Rockville, MD (United States)
  38. University of Tokyo (Japan); National Cancer Center, Tokyo (Japan)
  39. University of Texas, Houston, TX (United States)
  40. Seoul National University College of Medicine, Seoul (Korea, Republic of)
+ Show Author Affiliations
Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest. We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ~71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ~1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y. Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.
Research Organization:
National Academy of Sciences, Washington, DC (United States); Vanderbilt University, Nashville, TN (United States)
Sponsoring Organization:
USDOE Office of Environment, Health, Safety and Security (AU)
Grant/Contract Number:
HS0000031
OSTI ID:
1904819
Journal Information:
PLoS Medicine, Journal Name: PLoS Medicine Journal Issue: 4 Vol. 11; ISSN 1549-1676
Publisher:
Public Library of ScienceCopyright Statement
Country of Publication:
United States
Language:
English

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Cited By (15)

China through the lens of health in 2018 and beyond journal March 2018
Secondhand smoke exposure and risk of lung cancer in Japan: a systematic review and meta-analysis of epidemiologic studies journal August 2016
A Multicenter, Randomized, Double-blind, Parallel, Placebo-controlled Clinical Study to Evaluate the Efficacy and Safety of a Nicotine Mint Lozenge (2 and 4 mg) in Smoking Cessation journal January 2020
Smoking and Risk of All-cause Deaths in Younger and Older Adults journal January 2016
Association between educational level and total and cause-specific mortality: a pooled analysis of over 694 000 individuals in the Asia Cohort Consortium journal August 2019
Attributable causes of colorectal cancer in China journal January 2018
Primary prevention of cardiovascular disease in older adults in China journal January 2017
What Are the Major Determinants in the Success of Smoking Cessation: Results from the Health Examinees Study journal December 2015
High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study journal April 2018
Smoking-attributable burden of lung cancer in Mongolia a data synthesis study on differences between men and women journal February 2020
Poorer prognosis in Taiwanese female ever smokers with stage IV lung adenocarcinoma who were readministered a tyrosine kinase inhibitor journal March 2016
Association Between Smoking and Physician-Diagnosed Stroke and Myocardial Infarction in Male Adults in Korea journal January 2016
Familiarity, perception, and reasons for electronic-cigarette experimentation among the general public in Malaysia: Preliminary insight journal January 2016
NADPH Oxidase and the Cardiovascular Toxicity Associated with Smoking journal September 2014
Progress in Aptamer-Mediated Drug Delivery Vehicles for Cancer Targeting and Its Implications in Addressing Chemotherapeutic Challenges journal January 2014

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Related Subjects

60 APPLIED LIFE SCIENCES
Asia
South Korea
cancer risk factors
china
lung and intrathoracic tumors
smoking habits
smoking related disorders
tobacco control