The mortality risks of smokers in Taiwan: Part I: cause-specific mortality
Introduction
The adverse health effects of cigarette smoking have been studied extensively in the United States and other developed countries since the publication of the US Surgeon General's first report on smoking and health in 1964 [1]. The mortality risk from smoking has been generally grouped into three major categories: cancers, cardiovascular diseases, and respiratory diseases. A few recent studies have reported that smokers have higher rates of motor vehicle and other types of accidents than nonsmokers [2], [3], [4], [5], [6]. Many of these existing studies of adverse health effects from smoking were based on American, British, or other mostly Caucasian populations. Very limited studies of this type have been conducted on southeastern Asian populations. Because of the racial, cultural, and smoking behavioral differences (e.g., age of smoking initiation, duration of smoking, number of cigarettes smoked, types of cigarettes), the mortality patterns caused by cigarette smoking may differ between Caucasians and southeastern Asians.
The purpose of the study is to quantify the mortality risks from smoking and to establish baseline relative risks for various causes of death associated with smoking in Taiwan.
Section snippets
Methods
The study population for this investigation was derived from two existing prospective study cohorts. The first cohort, a community-based follow-up study, was established between 1982 and 1992 [7], [8]. The study subjects were selected from metropolitan precincts and urban and rural townships in northern, central, and southern Taiwan. The cohort consisted of 66,161 (37,196 males and 28,965 females) community residents 18 years old and older with no previous history of major diseases such as
Results
A total of 86,580 persons were included in this study; 61% were men and 39% were women (Table 1). The overall smoking prevalence was lower than in the general population for both men and women, [11] at 41% and 1.4%, respectively. The majority of men (86%) smoked one pack or fewer cigarettes a day, and 58% of them smoked cigarettes for more than 20 years (Table 2).
Discussion
To the best of our knowledge, this prospective follow-up cohort is one of the largest study populations in the assessing the mortality risks of smoking either in Taiwan or elsewhere in the world. The impact of smoking on a society is multifactorial, and can be measured in several dimensions. One of the most important dimensions is the burden of mortality. The accurate quantification of mortality risks associated with smoking is the critical first step in assessing the mortality burden of
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