Abstract
BackgroundQuantitative measures of the burden of tobacco smoking in Asian countries are limited. We estimated the population attributable fraction (PAF) of mortality associated with smoking in Japan, using pooled data from three large-scale cohort studies.MethodsIn total, 296,836 participants (140,026 males and 156,810 females) aged 40-79 years underwent baseline surveys during the 1980s and early 1990s. The average follow-up period was 9.6 years. PAFs for all-cause mortality and individual tobacco-related diseases were estimated from smoking prevalence and relative risks.ResultsThe prevalence of current and former smokers was 54.4% and 25.1% for males, and 8.1% and 2.4% for females. The PAF of all-cause mortality was 27.8% [95% confidence interval (CI): 25.2-30.4] for males and 6.7% (95% CI: 5.9-7.5) for females. The PAF of all-cause mortality calculated by summing the disease-specific PAFs was 19.1% (95% CI: 16.0-22.2) for males and 3.6% (95% CI: 3.0-4.2) for females. The estimated number of deaths attributable to smoking in Japan in 2005 was 163,000 for males and 33,000 for females based on the former set of PAFs, and 112,000 for males and 19,000 for females based on the latter set. The leading causes of smoking-attributable deaths were cancer (61% for males and 31% for females), ischemic heart diseases and stroke (23% for males and 51% for females), and chronic obstructive pulmonary diseases and pneumonia (11% for males and 13% for females).ConclusionThe health burden due to smoking remains heavy among Japanese males. Considering the high prevalence of male current smokers and increasing prevalence of young female current smokers, effective tobacco controls and quantitative assessments of the health burden of smoking need to be continuously implemented in Japan.
Highlights
Smoking is a major preventable cause of premature mortality
Estimating the mortality attributable to smoking is necessary in order to assess the health burden that it causes within a population, and such estimates have been performed in many countries and regions.[1,2,3,4,5]
Compared with the results of the historical Hirayama largescale cohort study,[13] the estimated age-adjusted relative risks in the present study were higher for all-cause mortality [1.6 vs. 1.3 for males, and 1.8 vs. 1.3 for females], for all cancers [2.0 vs. 1.7 for males, and 1.6 vs. 1.3 for females], for ischemic heart disease (IHD) [2.2 vs. 1.7 for males, and 3.0 vs. 1.9 for females], for stroke [1.3 vs. 1.1 for males, and 1.8 vs. 1.2 for females]
Summary
Smoking is a major preventable cause of premature mortality. Estimating the mortality attributable to smoking is necessary in order to assess the health burden that it causes within a population, and such estimates have been performed in many countries and regions.[1,2,3,4,5] In Japan, recent studies have estimated the population impact of smoking on selected causes of death, including all causes,[6] all cancers,[7] lung cancer,[8] pancreatic cancer,[9] and cardiovascular diseases.[10]. A historical large-scale cohort study in Japan, the Hirayama study, estimated the fraction of deaths attributable to smoking for many diseases among approximately 265,000 participants.[13] The baseline survey for the Hirayama study was conducted in 1965, and the follow-up was continued until the end of 1982. In the nearly 40 years since the Hirayama study began, the list of diseases known to be caused by smoking has been altered and expanded.[12] The purpose of the present study was, to estimate the population attributable fraction (PAF) of mortality caused by smoking in Japan in a comprehensive manner, based on the updated list of smoking-related diseases, and using data from nearly 300,000 participants of three large-scale Japanese cohort studies. Considering the high prevalence of male current smokers and increasing prevalence of young female current smokers, effective tobacco controls and quantitative assessments of the health burden of smoking need to be continuously implemented in Japan
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
