| Title: | Low-intensity daily smoking and cause-specific mortality in Mexico: prospective study of 150 000 adults |
| Journal: | International Journal of Epidemiology |
| Published: | 9 Jul 2021 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/33659992/ |
| DOI: | https://doi.org/10.1093/ije/dyab013 |
Publication 12
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Abstract
Background
Research is needed to determine the relevance of low-intensity daily smoking to mortality in countries such as Mexico, where such smoking habits are common.
Methods
Prospective study of 159 755 Mexican adults recruited from 1998-2004 and followed for cause-specific mortality to 1 January 2018. Participants were categorized according to baseline self-reported smoking status. Confounder-adjusted mortality rate ratios (RRs) at ages 35-89 were estimated using Cox regression, after excluding those with previous chronic disease (to avoid reverse causality).
Results
Among 42 416 men and 86 735 women aged 35-89 and without previous disease, 18 985 men (45%) and 18 072 women (21%) reported current smoking and 8866 men (21%) and 53 912 women (62%) reported never smoking. Smoking less than daily was common: 33% of male current smokers and 39% of female current smokers. During follow-up, the all-cause mortality RRs associated with the baseline smoking categories of <10 cigarettes per day (average during follow-up 4 per day) or ≥10 cigarettes per day (average during follow-up 10 per day), compared with never smoking, were 1.17 (95% confidence interval 1.10-1.25) and 1.54 (1.42-1.67), respectively. RRs were similar irrespective of age or sex. The diseases most strongly associated with daily smoking were respiratory cancers, chronic obstructive pulmonary disease and gastrointestinal and vascular diseases. Ex-daily smokers had substantially lower mortality rates than those who were current daily smokers at recruitment.
Conclusions
In this Mexican population, low-intensity daily smoking was associated with increased mortality. Of those smoking 10 cigarettes per day on average, about one-third were killed by their habit. Quitting substantially reduced these risks.
16 Authors
- Blake Thomson
- Roberto Tapia-Conyer
- Ben Lacey
- Sarah Lewington
- Raúl Ramirez-Reyes
- Diego Aguilar-Ramirez
- Louisa Gnatiuc
- William G Herrington
- Jason Torres
- Eirini Trichia
- Rachel Wade
- Rory Collins
- Richard Peto
- Pablo Kuri-Morales
- Jesus Alegre-Díaz
- Jonathan R Emberson