TY - JOUR
T1 - Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia
T2 - A Pooled Analysis of 21 Cohorts
AU - Zheng, Wei
AU - McLerran, Dale F.
AU - Rolland, Betsy A.
AU - Fu, Zhenming
AU - Boffetta, Paolo
AU - He, Jiang
AU - Gupta, Prakash Chandra
AU - Ramadas, Kunnambath
AU - Tsugane, Shoichiro
AU - Irie, Fujiko
AU - Tamakoshi, Akiko
AU - Gao, Yu Tang
AU - Koh, Woon Puay
AU - Shu, Xiao Ou
AU - Ozasa, Kotaro
AU - Nishino, Yoshikazu
AU - Tsuji, Ichiro
AU - Tanaka, Hideo
AU - Chen, Chien Jen
AU - Yuan, Jian Min
AU - Ahn, Yoon Ok
AU - Yoo, Keun Young
AU - Ahsan, Habibul
AU - Pan, Wen Harn
AU - Qiao, You Lin
AU - Gu, Dongfeng
AU - Pednekar, Mangesh Suryakant
AU - Sauvaget, Catherine
AU - Sawada, Norie
AU - Sairenchi, Toshimi
AU - Yang, Gong
AU - Wang, Renwei
AU - Xiang, Yong Bing
AU - Ohishi, Waka
AU - Kakizaki, Masako
AU - Watanabe, Takashi
AU - Oze, Isao
AU - You, San Lin
AU - Sugawara, Yumi
AU - Butler, Lesley M.
AU - Kim, Dong Hyun
AU - Park, Sue K.
AU - Parvez, Faruque
AU - Chuang, Shao Yuan
AU - Fan, Jin Hu
AU - Shen, Chen Yang
AU - Chen, Yu
AU - Grant, Eric J.
AU - Lee, Jung Eun
AU - Sinha, Rashmi
AU - Matsuo, Keitaro
AU - Thornquist, Mark
AU - Inoue, Manami
AU - Feng, Ziding
AU - Kang, Daehee
AU - Potter, John D.
PY - 2014/4
Y1 - 2014/4
N2 - Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.
AB - Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.
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U2 - 10.1371/journal.pmed.1001631
DO - 10.1371/journal.pmed.1001631
M3 - Article
C2 - 24756146
AN - SCOPUS:84900415399
SN - 1549-1277
VL - 11
JO - PLoS Medicine
JF - PLoS Medicine
IS - 4
M1 - e1001631
ER -