TY - JOUR
T1 - A Prospective Study of Tobacco Smoking and Mortality in Bangladesh
AU - Wu, Fen
AU - Chen, Yu
AU - Parvez, Faruque
AU - Segers, Stephanie
AU - Argos, Maria
AU - Islam, Tariqul
AU - Ahmed, Alauddin
AU - Rakibuz-Zaman, Muhammad
AU - Hasan, Rabiul
AU - Sarwar, Golam
AU - Ahsan, Habibul
PY - 2013/3/11
Y1 - 2013/3/11
N2 - Background: Limited data are available on smoking-related mortality in low-income countries, where both chronic disease burden and prevalence of smoking are increasing. Methods: Using data on 20, 033 individuals in the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh, we prospectively evaluated the association between tobacco smoking and all-cause, cancer, and cardiovascular disease mortality during ~7.6 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for deaths from all-cause, cancer, CVD, ischemic heart disease (IHD), and stroke, in relation to status, duration, and intensity of cigarette/bidi and hookah smoking. Results: Among men, cigarette/bidi smoking was positively associated with all-cause (HR 1.40, 95% CI 1.06 1.86) and cancer mortality (HR 2.91, 1.24 6.80), and there was a dose-response relationship between increasing intensity of cigarette/bidi consumption and increasing mortality. An elevated risk of death from ischemic heart disease (HR 1.87, 1.08 3.24) was associated with current cigarette/bidi smoking. Among women, the corresponding HRs were 1.65 (95% CI 1.16 2.36) for all-cause mortality and 2.69 (95% CI 1.20 6.01) for ischemic heart disease mortality. Similar associations were observed for hookah smoking. There was a trend towards reduced risk for the mortality outcomes with older age at onset of cigarette/bidi smoking and increasing years since quitting cigarette/bibi smoking among men. We estimated that cigarette/bidi smoking accounted for about 25.0% of deaths in men and 7.6% in women. Conclusions: Tobacco smoking was responsible for substantial proportion of premature deaths in the Bangladeshi population, especially among men. Stringent measures of tobacco control and cessation are needed to reduce tobacco-related deaths in Bangladesh.
AB - Background: Limited data are available on smoking-related mortality in low-income countries, where both chronic disease burden and prevalence of smoking are increasing. Methods: Using data on 20, 033 individuals in the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh, we prospectively evaluated the association between tobacco smoking and all-cause, cancer, and cardiovascular disease mortality during ~7.6 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for deaths from all-cause, cancer, CVD, ischemic heart disease (IHD), and stroke, in relation to status, duration, and intensity of cigarette/bidi and hookah smoking. Results: Among men, cigarette/bidi smoking was positively associated with all-cause (HR 1.40, 95% CI 1.06 1.86) and cancer mortality (HR 2.91, 1.24 6.80), and there was a dose-response relationship between increasing intensity of cigarette/bidi consumption and increasing mortality. An elevated risk of death from ischemic heart disease (HR 1.87, 1.08 3.24) was associated with current cigarette/bidi smoking. Among women, the corresponding HRs were 1.65 (95% CI 1.16 2.36) for all-cause mortality and 2.69 (95% CI 1.20 6.01) for ischemic heart disease mortality. Similar associations were observed for hookah smoking. There was a trend towards reduced risk for the mortality outcomes with older age at onset of cigarette/bidi smoking and increasing years since quitting cigarette/bibi smoking among men. We estimated that cigarette/bidi smoking accounted for about 25.0% of deaths in men and 7.6% in women. Conclusions: Tobacco smoking was responsible for substantial proportion of premature deaths in the Bangladeshi population, especially among men. Stringent measures of tobacco control and cessation are needed to reduce tobacco-related deaths in Bangladesh.
UR - http://www.scopus.com/inward/record.url?scp=84874856451&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84874856451&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0058516
DO - 10.1371/journal.pone.0058516
M3 - Article
C2 - 23505526
AN - SCOPUS:84874856451
SN - 1932-6203
VL - 8
JO - PloS one
JF - PloS one
IS - 3
M1 - e58516
ER -