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: name: Zheng, Wei
name: McLerran, Dale F.
name: Rolland, Betsy A.
name: Fu, Zhenming
name: Boffetta, Paolo
name: He, Jiang
name: Gupta, Prakash Chandra
name: Ramadas, Kunnambath
name: Tsugane, Shoichiro
name: Irie, Fujiko
name: Tamakoshi, Akiko
name: Gao, Yu-Tang
name: Koh, Woon-Puay
name: Shu, Xiao-Ou
name: Ozasa, Kotaro
name: Nishino, Yoshikazu
name: Tsuji, Ichiro
name: Tanaka, Hideo
name: Chen, Chien-Jen
name: Yuan, Jian-Min
name: Ahn, Yoon-Ok
name: Yoo, Keun-Young
name: Ahsan, Habibul
name: Pan, Wen-Harn
name: Qiao, You-Lin
name: Gu, Dongfeng
name: Pednekar, Mangesh Suryakant
name: Sauvaget, Catherine
name: Sawada, Norie
name: Sairenchi, Toshimi
name: Yang, Gong
name: Wang, Renwei
name: Xiang, Yong-Bing
name: Ohishi, Waka
name: Kakizaki, Masako
name: Watanabe, Takashi
name: Oze, Isao
name: You, San-Lin
name: Sugawara, Yumi
name: Butler, Lesley M.
name: Kim, Dong-Hyun
name: Park, Sue K.
name: Parvez, Faruque
name: Chuang, Shao-Yuan
name: Fan, Jin-Hu
name: Shen, Chen-Yang
name: Chen, Yu
name: Grant, Eric J.
name: Lee, Jung Eun
name: SInha, Rashmi
name: Matsuo, Keitaro
name: Thornquist, Mark
name: Inoue, Manami
name: Feng, Ziding
name: Kang, Daehee
name: Potter, John D.
Publisher: name: Columbia University
Year: 2014
Subjects: Smoking
Tobacco use
Tobacco--Health aspects
Tobacco use--Mortality
Smoking--Mortality
Cigarette smokers--Mortality
Tobacco
Epidemiology
Public health

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.