Background There is controversy about whether men and women with similar smoking histories have similar incidence and mortality rates from smoking related diseases.
Objective To compare mortality rates from all causes of death and various smoking related causes for men and women smokers categorised by numbers of cigarettes smoked and for ex-smokers by time since quitting.
Methods This was a 10-year follow-up study with deaths identified from the National Death Index. The setting was two cohort studies in Australia established in 1996. Participants were: men (n=12 154) and women (n=11 707) aged (mean (SD)) 72.1 (4.4) and 72.5 (1.5) years, respectively, when recruited. The main outcome measure was HRs for men and women separately and RRs calculated from combined analyses using proportional hazards models (for deaths from all causes) and competing risks proportional hazards models (for specific causes).
Results HRs for deaths from all causes for men (n=3549 deaths) and women (n=2665 deaths) among smokers increased with amount smoked and for ex-smokers decreased with time since quitting. Similar effects were found for various groups of smoking-related conditions with the dose-response effects largest for lung cancer and chronic obstructive pulmonary disease. The ratios of HRs for women relative to men were near unity and the 95% CIs included unity for almost all comparisons.
Conclusions The data provide strong evidence that men and women with similar patterns of smoking experience similar rates of death due to smoking.
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Funding The Men, Women and Ageing project is funded by a National Health and Medical Research Council of Australia/Australian Research Council Ageing Well, Ageing Productively Strategic Award (409953). The Australian Longitudinal Study on Women's Health is funded by the Australian Government Department of Health and Ageing. The Health in Men Study is supported by grants from the National Health and Medical Research Council of Australia (project grant numbers 279408, 379600, 403963). The funding sources had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; or preparation, review, or approval of the manuscript.
Competing interests All authors (except KJ) have completed the Unified Competing Interest form at http://www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and all authors (except KJ) wish to declare (1) financial support for the submitted work from the National Health and Medical Research Council and the Australian Government Department of Health and Ageing. All authors also declare (2) no financial relationships with commercial entities that might have an interest in the submitted work; (3) no spouses, partners or children with relationships with commercial entities that might have an interest in the submitted work; (4) no non-financial interests that may be relevant to the submitted work.
Ethics approval This study was conducted with the approval of the The Human Research Ethics Committee of the University of Western Australia approved the protocol for the Health in Men Study and human research ethics committees at the University of Newcastle and at the University of Queensland approved that for the Australian Longitudinal Study on Women's Health.
Provenance and peer review Not commissioned; externally peer reviewed.
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