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European Journal of Epidemiology

, Volume 22, Issue 5, pp 301–309 | Cite as

Mortality risks among heavy-smokers with special reference to women: a long-term follow-up of an urban population

  • M. Ekberg-Aronsson
  • P. M. Nilsson
  • J.-Å. Nilsson
  • C.-G. Löfdahl
  • K. Löfdahl
Mortality

Abstract

Increased mortality risks associated with smoking are well established among men. There are very few population-based studies comprising a sufficient number of heavily smoking women, measuring the direct effect of smoking on mortality risks. Between 1974 and 1992, 8,499 women and 13,888 men attended a health screening programme including reporting of smoking habits. Individuals were followed for total mortality until 2005. All-cause, cancer, cardiovascular, lung cancer and respiratory mortality were calculated in smoking categories <10 g per day, 10–19 g per day, and ≥20 g per day with never-smokers as a reference group and with adjustments for co-morbidities, socio-economic and marital status. For respiratory mortality and lung cancer adjustments for FEV1, socio-economic and marital status were performed. Smoking was associated with a two to almost threefold increased mortality risk among women and men. The relative risk (RR) with 95% confidence interval, (CI) for women who smoked 10–19 g per day was 2.44 (2.07–2.87), and for those who smoked 20 g per day or more the RR (95% CI) was 2.42 (2.00–2.92). Smoking was a strong risk factor for cardiovascular mortality among women, the RR (95% CI) for women who smoked 10–19 g per day was 4.52 (3.07–6.64). Ex-smoking women showed increased risks of all-cause mortality; RR (95% CI) 1.26 (1.04–1.52) cancer (excluding lung cancer); RR (95% CI) 1.42 (1.07–1.88) and lung cancer RR (95% CI) 2.71 (1.02–7.23) mortality. However, the cardiovascular; RR (95% CI) 1.18 (0.69–2.00) and respiratory; RR (95% CI) 0.79 (0.16–3.84) mortality risks were not statistically significant. This study confirms that as for men, middle-aged heavily smoking women have a two to threefold increased mortality risk. Adjustments for co-morbidity, socio-economic and marital status did not change these results.

Keywords

Epidemiology Men Mortality Smoking Tobacco Women 

Notes

Acknowledgement

This study was supported by grants from the Swedish Heart and Lung Foundation. Ethical approval When MPP was started in 1974 no Ethical Committee was available to approve of the baseline screening examination. The screening was at that time regarded as an integrated part of routine health care. All participating subjects agreed to have follow-up of clinical events and register follow-up. This has been confirmed by approval of the Swedish Data register authorities (“Data-inspektionen” in decision 1997-06-24; Dnr 2403-97). A new application to the Ethical committee of the Medical Faculty, University of Lund, was approved in August 2002 (LU 244-02), and for genetic analyses (Lund protocol 2004/3, Dnr. 154/2004).

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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • M. Ekberg-Aronsson
    • 1
  • P. M. Nilsson
    • 2
  • J.-Å. Nilsson
    • 2
  • C.-G. Löfdahl
    • 1
  • K. Löfdahl
    • 1
  1. 1.Department of Respiratory Medicine and Allergology, Lund University HospitalUniversity of LundLundSweden
  2. 2.Department of Clinical Sciences, Malmö University HospitalUniversity of LundMalmoSweden

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