Morbidity and mortality in relation to smoking among women and men of Chinese ethnicity: The Singapore Chinese Health Study

Abstract

Objectives-We examined the association among cigarette smoking, smoking cessation and a broad range of cancer incidence and all cause and cause-specific mortality in a population-based cohort of adults of Chinese ethnicity in Singapore.Methods-Subjects were 61,320 participants of the Singapore Chinese Health Study (44.5% men, aged 45-74 years, recruitment from 1993-1998) who were free of cancer at the baseline examination. Main outcomes-of-interest included cancer incidence, all cause and cause-specific mortality as of December 31, 2005.Results-Cigarette smoking was positively associated with overall cancer incidence, including cancers at the following specific sites: head and neck region, upper gastrointestinal tract, hepatobiliary and pancreas cancer, lung, and bladder/renal pelvis cancer. Compared to never smokers, the relative risk (RR) (95% confidence interval [CI]) of cancer incidence (all cancer sites) among current smokers smoking >22 cigarettes/day was 1.9 (1.7-2.1), p-trend<0.0001. Similarly, cigarette smoking was associated with all cause and cause-specific mortality, including deaths due to cancer, ischemic heart disease, other heart diseases, and chronic obstructive pulmonary disease. Compared to never smokers, RR (95%CI) of all cause mortality among current smokers smoking >22 cigarettes/day was 1.8 (1.6-2.0), p-trend<0.0001. Also, relative to current smokers, ex-smokers experienced reduced cancer incidence and total mortality. The population attributable risk of smoking in men for cancer incidence as well as all-cause mortality was 23%, whereas in women it ranged from 4-5%.Conclusions-Cigarette smoking is an important risk factor for cancer incidence and major causes of mortality in Chinese men and women of Singapore.

Smoking as a Risk Factor for Stroke in Women Compared With Men

“…After full-text evaluation, 16 articles were selected that provided information from 34 cohorts on sex differences in the association between smoking and stroke in the general population (Table). 5,6,15,16,[25][26][27][28][29][30][31][32][33][34][35] These data were extended with data from ARIC, 18 NHANES III, 19 APCSC, 20 and SHHEC, 21 adding a further 47 cohorts. Baseline characteristics of all 81 cohorts included in this study are described in the Table. Overall, data on 3 980 359 individuals were available, in whom ≥42 401 fatal and nonfatal strokes were documented (1 study, including 56 167 individuals, did not report the number of stroke events).…”

Estimating the decline in excess risk of chronic obstructive pulmonary disease following quitting smoking – A systematic review based on the negative exponential model

“…(Boggia et al, 2008;Gratziou, 2009;Jindal et al, 2006;Løkke et al, 2006;Pelkonen et al, 2006;Pelkonen, 2008;Sai et al, 2007;Sarna et al, 2008;Shankar et al, 2008;Streppel et al, 2007). Repeating the search in August 2012 identified two more potentially suitable papers (Jamrozik et al, 2011;Omori et al, 2011).…”

“…This left 11 publications (Alderson et al, 1986;Dean et al, 1977;Forastiére et al, 1998;Friedman et al, 1997;Huhti and Ikkala, 1980;Jacobs et al, 1999;Jamrozik et al, 2011;Krzyzanowski et al, 1986;Mannino et al, 2003;Rogot and Murray, 1980;Shankar et al, 2008) describing independent studies appearing to satisfy the inclusion and exclusion criteria. Table 1 gives selected details of these studies.…”

Consequences of Smoking during Pregnancy on Maternal Health

“…7 Besides increasing the risk of cardiovascular morbidity, 8 smoking in a nonpregnant woman also increases her risk of pulmonary morbidity. [8][9][10][11] The effects of smoking on the outcomes of pregnancy are well documented and include an increased risk of preterm premature rupture of the membranes (PPROM), preterm birth, low birth weight, placenta previa, and placental abruption 8 ; however, there are fewer data on the effects of smoking on the health of the women themselves during pregnancy. The purpose of this study was primarily to estimate the extent of maternal cardiovascular and pulmonary morbidity among pregnant smokers and secondarily to estimate adverse pregnancy outcomes.…”