Smoking and mortality in a prospective cohort study of elderly Chinese in Hong Kong

Lam, Tai Hing; Xu, Lin; Schooling, CM; Chan, Wai Man; Lee, Siu Y.; Leung, Gabriel M.

doi:10.1111/add.12776

Cited by 21 publications

(14 citation statements)

References 24 publications

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“…Guangzhou is close (about 120 km) to Hong Kong, which has an advanced stage of tobacco epidemic [ 22 ] and a mortality relative risk of about 2 in people aged 65 years or more [ 23 ]. But participants of the Hong Kong cohort were recruited in 1998–2001 and born in the 1930s [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study

Lam¹,

Jiang

et al. 2018

PLoS ONE

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BackgroundPrediction of disease burden in China arising from smoking based on earlier cohorts in the West and China could not reflect the disease burden at the current stage accurately. No cohort studies in China focused specifically on people born since 1950. We examined the risk of all-cause mortality attributed to smoking in adults in Guangzhou, the city with the most rapidly expanding economy in China.Methods and findingsThis population-based prospective cohort included 21,658 women and 8,284 men aged 50+ years enrolled from 2003–2008 and followed until January 2016. During an average follow-up of 8.8 (standard deviation = 1.8) years, 2,986 (1,586 women, 1,400 men) deaths were recorded. After adjustment for confounders, the hazards ratios (95% confidence interval (CI)) of all-cause mortality in current versus never smokers increased from 1.61 (95% CI 1.45–1.80) in those born in 1920–1939 to 2.02 (95% CI 1.74–2.34), and 4.40 (95% CI 3.14–6.17), in those born in the 1940s and 1950s, respectively (P for trend 0.009).ConclusionsIn smokers born after 1949 in Guangzhou and other areas which have the longest history of smoking, the mortality risk could have reached three fold that of non-smokers, as in the UK, US and Australia. If confirmed, unless China quickly and strictly complies with the WHO Framework Convention on Tobacco Control with massive smoking cessation in the population, this is a more striking warning that China will be facing an even larger disease burden from tobacco use than previous forecasts.

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Section: Discussionmentioning

confidence: 99%

High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study

Lam¹,

Jiang

et al. 2018

PLoS ONE

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“…In the stratification of smoker, alcohol drinker, T2DM, and obesity, the U-shaped association between sleep duration and all-cause mortality was not statistically significant. This may be caused by the stronger association between smoking, 30 alcohol drinking, 31 T2DM and obesity, 32 and all-cause mortality. In the underweight population, sleeping fewer than 6.5 hours could reduce the risk of death and this situation may result from nutrition status, potential increasing physical activity, or the smaller sample size with underweight stratification A meta-regression of 40 prospective cohort studies also confirmed that as compared with 7 hours of sleep, both shortened and prolonged sleep durations were associated with increased risk of all-cause mortality.…”

Section: Discussionmentioning

confidence: 99%

Sleep Duration Interacts With Lifestyle Risk Factors and Health Status to Alter Risk of All-Cause Mortality: The Rural Chinese Cohort Study

Liu

Zhang

Liu

et al. 2018

Journal of Clinical Sleep Medicine

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“…National smoking prevalence of manufactured cigarettes by age group was obtained from the Global Adult Tobacco Survey (GATS) China Report 2010 for ages 15–69 [ 28 ] ( Table 1 ). A study of smoking among elderly in Hong Kong was used to estimate the smoking prevalence in men above age 70 [ 29 ]. The future smoking prevalence of those under age 15 was assumed to be the prevalence among 15– to 19–year–olds; and no additional smoking initiation would take place among those above age 15.…”

Section: Methodsmentioning

confidence: 99%

Distributional benefits of tobacco tax and smoke–free workplaces in China: A modeling study

Verguet¹,

Tarr²,

Gauvreau³

et al. 2017

Journal of Global Health

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BackgroundTobacco taxation and smoke–free workplaces reduce smoking, tobacco–related premature deaths and associated out–of–pocket health care expenditures. We examine the distributional consequences of a price increase in tobacco products through an excise tax hike, and of an implementation of smoke–free workplaces, in China.MethodsWe use extended cost–effectiveness analysis (ECEA) to evaluate, across income quintiles of the male population (the large majority of Chinese smokers), the premature deaths averted, the change in tax revenues generated, and the financial risk protection procured (eg, poverty cases averted, defined as the number of individuals no longer facing tobacco–related out–of–pocket expenditures for disease treatment, that would otherwise impoverish them), that would follow a 75% increase in cigarette prices through substantial increments in excise tax fully passed onto consumers, and a nationwide total implementation of workplace smoking bans.ResultsA 75% increase in cigarette prices would avert about 24 million premature deaths among the current Chinese male population, with a third among the bottom income quintile, increase additional tax revenues by US$ 46 billion annually, and prevent around 9 million poverty cases, 19% of which among the bottom income quintile. Implementation of smoking bans in workplaces would avert about 12 million premature deaths, with a fifth among the bottom income quintile, decrease tax revenues by US$ 7 billion annually, and prevent around 4 million poverty cases, 12% of which among the bottom income quintile.ConclusionsIncreased excise taxes on tobacco products and workplace smoking bans can procure large health and economic benefits to the Chinese population, especially among the poor.

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Smoking and mortality in a prospective cohort study of elderly Chinese in Hong Kong

Abstract: In Hong Kong, the risk of death from smoking appears to be the same for Chinese women as it is for men. Half of all deaths in Chinese smokers aged 65 years and older and a quarter of all deaths in Chinese smokers aged 85 years and older are caused by smoking-attributable diseases.

Cited by 21 publications

References 24 publications

High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study

High relative risk of all-cause mortality attributed to smoking in China: Guangzhou Biobank Cohort Study

Sleep Duration Interacts With Lifestyle Risk Factors and Health Status to Alter Risk of All-Cause Mortality: The Rural Chinese Cohort Study

Distributional benefits of tobacco tax and smoke–free workplaces in China: A modeling study

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