Excess mortality among cigarette smokers: changes in a 20-year interval.

Thun, Michael J.; Day-Lally, C A; Calle, Eugenia E.; Flanders, W. Dana; Heath, Clark W.

doi:10.2105/ajph.85.9.1223

Cited by 166 publications

(90 citation statements)

References 23 publications

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“…15 These results suggest that the differences between survival expectations and actuarial predictions presented in Table 2 are too large to be explained by period trends of the size and direction observed in the last 20 years.…”

Section: Discussionmentioning

confidence: 81%

Do smokers understand the mortality effects of smoking? Evidence from the Health and Retirement Survey.

Schoenbaum

1997

Am J Public Health

120

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OBJECTIVES: This study examined whether smokers recognize that smoking is likely to shorten their lives and, if so, whether they understand the magnitude of this effect. METHODS: People's expectations about their chances of reaching age 75 were compared with epidemiological predictions from life tables for never, former, current light, and current heavy smokers. Data on expectations of reaching age 75 came from the Health and Retirement Survey, a national probability sample of adults aged 50 through 62 years. Predictions came from smoking-specific life tables constituted from the 1986 National Mortality Followback Survey and the 1985 and 1987 National Health Interview Surveys. RESULTS: Among men and women, the survival expectations of never, former, and current light smokers were close to actual predictions. However, among current heavy smokers, expectations of reaching age 75 were nearly twice as high as actuarial predictions. CONCLUSIONS: These findings suggest that at least heavy smokers significantly underestimate their risk of premature mortality.

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Section: Discussionmentioning

confidence: 81%

Do smokers understand the mortality effects of smoking? Evidence from the Health and Retirement Survey.

Schoenbaum

1997

Am J Public Health

120

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“…These figures should be interpreted with caution, however, because information on the number of cigarettes smoked at baseline may not represent the lifelong patterns of smoking that cause lung cancer. 38 In the comparison of CPS I and II, no substantial difference was observed in terms of number of cigarette per day or age at initiating smoking between the 2 cohorts, but the relative risk markedly increased in CPS II. The authors speculated that smokers in CPS II may be more heavily exposed to cigarettes in their adolescence and early adulthood and also may become more addicted "hardcore" smokers with a tendency to inhale more deeply, take more puffs per cigarette and retain the smoke longer in their lungs.…”

Section: Discussionmentioning

confidence: 90%

Cigarette smoking and subsequent risk of lung cancer by histologic type in middle‐aged Japanese men and women: The JPHC study

Sobue

Yamamoto

Hara

et al. 2002

Intl Journal of Cancer

142

115

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In order to update the findings of relative risk associated with cigarette smoking for lung cancer by histologic type in Japan, the data from a population-based cohort study of 91,738 men and women were analyzed. During 1990 -1999, 422 lung cancer incident cases were identified. The relative risk for all incident cases associated with current smokers versus non-smokers was 4.5 [95% confidence interval (CI): 3.0 -6.8] and 4.2 (95% CI: 2.4 -7.2), for men and women, respectively. When divided by histologic type, relative risk for squamous cell carcinoma and small cell carcinoma was 12.7 (95% CI: 4.7-34.7) and 17.5 (95% CI: 4.9 -62.1), while for adenocarcinoma it was 2.8 (95% CI: 1.6 -4.9) and 2.0 (95% CI: 0.8 -5.0) for men and women, respectively. We confirmed that the lung cancer risk in men rose with increasing cigarette smoking, especially the duration of smoking among current smokers and decreased after the cessation of smoking among former smokers. Unlike the US or European countries, the relative risk did not increase in this updated study, compared with previous studies in 1960s to 1990s in Japan either for all incident cases or for specific histologic types and the magnitude of relative risks was substantially lower than that observed in the US or European countries, especially for adenocarcinoma. © 2002 Wiley-Liss, Inc. Key words: lung cancer; histologic type; cigarette smoking; relative riskRecent trends in lung cancer incidence showed a relative increase in adenocarcinoma as compared with squamous cell carcinoma for both men and women in various countries. [1][2][3][4][5][6] It is hypothesized that this trend is mainly due to the dissemination of low-tar filter cigarettes, 7-9 since filters mainly remove the larger particles in cigarette smoke, which tend to be deposited in the central large bronchus where most squamous cell carcinomas arise. However, such filters do not remove smaller particles, which tend to reach the peripheral region of the lung where adenocarcinomas arise. Moreover, in order to compensate for nicotine intake, smokers of low-tar filter cigarettes tend to inhale more deeply than those of nonfilter cigarettes, which results in more cigarette smoke reaching the peripheral region. Switching from nonfilter to filter cigarettes occurred mostly during in the US, the UK and Japan, where market share of filtered cigarette exceeded that of nonfilter cigarette in 1959, 1967 and 1965, respectively. 10,11 In the US and European countries, this hypothesis is supported by the finding that the magnitude of the relative risk of lung adenocarcinoma associated with cigarette smoking increased in recent studies, just when the usage of low-tar filter cigarette became more widespread among study subjects. It is reported from the US that the risk of lung adenocarcinoma is many times higher for current smokers than non-smokers, i.e., 19.0-fold for men and 8.1-fold for women in the Cancer Prevention Study (CPS) II (1982II ( -1984, while in CPS I (1959 -1961) corresponding estimates were 4.6 and 1.5 for me...

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“…11 During the intervening 20 to 25 years, the relative risk of death from lung cancer had increased to 11.94 (95% CI, 9.99 to 14.26) for female smokers and to 22.36 (95% CI, 17.77 to 28.13) for male smokers. 10,12 Several factors may have altered the health risks incurred by smokers. Smoking patterns have changed.…”

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confidence: 99%