Abstract
BackgroundTobacco smoking is known to be the single largest cause of premature death worldwide. The aim of present study was to analyse the effect of smoking on general and cause-specific mortality in the Estonian population.MethodsThe data from 51,756 adults in the Estonian Genome Center of the University of Tartu was used. Information on dates and causes of death was retrieved from the National Causes of Death Registry. Smoking status, general survival, general mortality and cause-specific mortality were analysed using Kaplan-Meier estimator and Cox proportional hazards models.ResultsThe study found that smoking reduces median survival in men by 11.4 years and in women by 5.8 years. Tobacco smoking produces a very specific pattern in the cause of deaths, significantly increasing the risks for different cancers and cardiovascular diseases as causes of death for men and women. This study also identified that external causes, such as alcohol intoxication and intentional self-harm, are more prevalent causes of death among smokers than non-smokers. Additionally, smoking cessation was found to reverse the increased risks for premature mortality.ConclusionsTobacco smoking remains the major cause for losses of life inducing cancers and cardiovascular diseases. In addition to the common diseases, external causes also reduce substantially the years of life. External causes of death indicate that smoking has a long-term influence on the behaviour of smokers, provoking self-destructive behaviour. Our study supports the idea, that tobacco smoking generates complex harm to our health increasing mortality from both somatic and mental disorders.
Highlights
Tobacco smoking is known to be the single largest cause of premature death worldwide
While it is clear that smoking increases mortality, the association between smoking and mortality is different across specific causes of death
Mortality information was retrieved from the Estonian Causes of Death Registry and last retrieval was performed in September 2015
Summary
Tobacco smoking is known to be the single largest cause of premature death worldwide. The aim of present study was to analyse the effect of smoking on general and cause-specific mortality in the Estonian population. Tobacco smoking is a single major cause of premature death worldwide [1, 2]. Despite substantial reduction in the use of tobacco, smoking still causes more deaths globally than diseases like tuberculosis, HIV and malaria combined, making it the largest preventable health risk factor [3, 4]. It has been estimated that tobacco smoking causes globally 6 million deaths in a year [6]. While it is clear that smoking increases mortality, the association between smoking and mortality is different across specific causes of death. Chronic obstructive diseases of respiratory system and cardiovascular diseases are the most commonly referred smokinginduced causes of death
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