Biological Sciences Division
Published April 22, 2014 | Version v1
Journal article Open

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

Creators

  • 1. Vanderbilt University
  • 2. Fred Hutchinson Cancer Research Center
  • 3. Ichan School of Medicine at Mount Sinai
  • 4. Tulane University
  • 5. Healis-Sekhsaria Institute for Public Health
  • 6. Regional Cancer Center
  • 7. National Cancer Center
  • 8. Ibaraki Prefectural Government
  • 9. Aichi Medical University
  • 10. Shanghai Cancer Institute
  • 11. National University of Singapore
  • 12. Radiation Effects Research Foundation
  • 13. Miyagi Cancer Center Research Institute
  • 14. Tohoku University
  • 15. National Taiwan University
  • 16. University of Pittsburgh
  • 17. Seoul National University
  • 18. University of Chicago

Description

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.

Notes

Due to the large number of authors, only the first 20 and the University of Chicago authors are included on the above author list. Please download the article for the complete list of authors.

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Additional details

Identifiers

DOI
10.1371/journal.pmed.1001631
Other
oai:uchicago.tind.io:10890

Funding

Centre international de recherche sur le cancer
Worldwide Cancer Research
Cancer Research UK
National Institutes of Health
P42ES010349
National Institutes of Health
R01CA102484
National Institutes of Health
R01CA107431
American Heart Association
9750612N
National Heart Lung and Blood Institute
U01-HL072507
China Academy of Chinese Medical Sciences
Unknown funder
Shanghai Cohort Study
National Institutes of Health
R01CA0403092
National Institutes of Health
R01CA144034
National Institutes of Health
R01-CA82729
National Institutes of Health
R37-CA70867
Department of Health
DOH80-27
Department of Health
DOH81-021
Department of Health
DOH8202-1027
Department of Health
DOH83-TD-015
Department of Health
DOH84-TD-006
National Institutes of Health
R01CA55069
National Institutes of Health
R35CA53890
National Institutes of Health
R01CA80205
Ministry of Education
2009-0087452
National Research Foundation of Korea
2009-0087452
Ministry of Health Labour and Welfare
United States Department of Energy
United States Department of Energy
DE-HS0000031
Ministry of Health Labour and Welfare
Grantin-aid for Cancer Research
Ministry of Health Labour and Welfare
Grant for the Third Term Comprehensive Control Research for Cancer
Ministry of Health Labour and Welfare
Grant for Health Services
Ministry of Health Labour and Welfare
Grant for Medical Services for Aged and Health Promotion
Ministry of Health Labour and Welfare
Grant for Comprehensive Research on Cardiovascular and Life-style Related Diseases
Ministry of Education, Culture, Sports, Science and Technology
Grant for Scientific Research
National Cancer Center
Research and Development Fund

UChicago Information

Division(s)
Biological Sciences Division
Department(s)
Human Genetics, Medicine, Public Health Sciences