Smoking as a risk factor for accident death: a meta-analysis of cohort studies

Abstract

This meta-analysis discusses the consistency, strength, dose-response, independence, and generalizability of published cohort data on accident death relative risks in smokers. To locate data, three authors independently searched MEDLINE, and bibliographies of the pertinent studies found, for data which allowed estimation of an appropriate cigarette smoker accident death relative risk (and 95% confidence interval). Relative risks and dose-response were summarized by fixed effects and Poisson modeling, respectively. Four pertinent cohort studies including eight populations were located. Cigarette smoking predicted summary accident death relative risks of 1.51 (95% confidence interval 1.27-1.78) versus never smokers and 1.35 (1.17-1.57) versus ex-smokers. Summary dose-response trends were significant (P = 0.0000) versus never or least smoking referents. In individual studies, the smoking/accident death association persisted after adjustment or, in effect stratification, for age, race, sex, and occupation; occupation and time period; or numerous cardiac risk factors. This meta-analysis found significant, consistent, dose-response, often strong and independent (of age, race, and sex), prospective associations of smoking with accident death, internationally. Further studies and warnings of the smoking/accident death associations seem merited.

Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration

“…Although our analyses did not adjust for education or socio economic status or personality, variables that were not collected in the APCSC, our finding of a positive association between smoking and mortality from injury in cohorts from ANZ is consistent with findings from a meta-analysis of four studies from the USA and Northern Europe 30. In that meta-analysis, a dose–response relationship between smoking and injuries was observed, and this persisted after adjustment for alcohol consumption and socioeconomic status.…”

Fatigue as a risk factor for being injured in an occupational accident: results from the Maastricht Cohort Study

“…These include age, 2 alcohol consumption and smoking, [3][4][5][6] shift work, 7 8 and circumstantial factors-that is, factors describing the situational circumstances under which the accident took place. 9 In their literature review, Hsiao and Simeonov present a model for structuring factors that play a role in falls from roofs, which can also be applied to occupational accidents in general.…”

Predictors of injury mortality: findings from a large national cohort in Thailand

“…The effect of smoking on injury was also shown in other studies after controlling for covariates including alcohol drinking. Plausible explanations include accidental fire hazard and distraction or inattention for road traffic hazards 25 26. Non-transport injury deaths presented here reflected the current political situation with violence in the southern part of Thailand since 2004 28 29.…”

“…These behaviours included smoking and alcohol drinking which have been shown to be independently associated with injury 25 26. Smoking status includes never, current and former and alcohol status includes never, occasional, regular and former.…”