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

Zheng, W and McLerran, DF and Rolland, BA and Fu, Z and Boffetta, P and He, J and Gupta, PC and Ramadas, K and Tsugane, S and Irie, F and Tamakoshi, A and Gao, YT and Koh, WP and Shu, XO and Ozasa, K and Nishino, Y and Tsuji, I and Tanaka, H and Chen, CJ and Yuan, JM and Ahn, YO and Yoo, KY and Ahsan, H and Pan, WH and Qiao, YL and Gu, D and Pednekar, MS and Sauvaget, C and Sawada, N and Sairenchi, T and Yang, G and Wang, R and Xiang, YB and Ohishi, W and Kakizaki, M and Watanabe, T and Oze, I and You, SL and Sugawara, Y and Butler, LM and Kim, DH and Park, SK and Parvez, F and Chuang, SY and Fan, JH and Shen, CY and Chen, Y and Grant, EJ and Lee, JE and Sinha, R and Matsuo, K and Thornquist, M and Inoue, M and Feng, Z and Kang, D and Potter, JD (2014) Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts. PLoS Medicine, 11 (4). ISSN 1549-1277

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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. © 2014 Zheng et al.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Zheng, W
McLerran, DF
Rolland, BA
Fu, Z
Boffetta, P
He, J
Gupta, PC
Ramadas, K
Tsugane, S
Irie, F
Tamakoshi, A
Gao, YT
Koh, WP
Shu, XO
Ozasa, K
Nishino, Y
Tsuji, I
Tanaka, H
Chen, CJ
Yuan, JMyuanj@pitt.eduYUANJ
Ahn, YO
Yoo, KY
Ahsan, H
Pan, WH
Qiao, YL
Gu, D
Pednekar, MS
Sauvaget, C
Sawada, N
Sairenchi, T
Yang, G
Wang, Rrew59@pitt.eduREW59
Xiang, YB
Ohishi, W
Kakizaki, M
Watanabe, T
Oze, I
You, SL
Sugawara, Y
Butler, LMbutlerl3@pitt.eduBUTLERL3
Kim, DH
Park, SK
Parvez, F
Chuang, SY
Fan, JH
Shen, CY
Chen, Y
Grant, EJ
Lee, JE
Sinha, R
Matsuo, K
Thornquist, M
Inoue, M
Feng, Z
Kang, D
Potter, JD
ContributionContributors NameEmailPitt UsernameORCID
Date: 1 January 2014
Date Type: Publication
Journal or Publication Title: PLoS Medicine
Volume: 11
Number: 4
DOI or Unique Handle: 10.1371/journal.pmed.1001631
Schools and Programs: School of Public Health > Epidemiology
Refereed: Yes
ISSN: 1549-1277
Date Deposited: 02 Jul 2014 21:33
Last Modified: 02 Feb 2019 16:56


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