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The effects of smoking and smoking cessation on mortality from cardiovascular disease among Japanese: pooled analysis of three large-scale cohort studies in Japan
  1. Kaori Honjo1,
  2. Hiroyasu Iso1,
  3. Shoichiro Tsugane2,
  4. Akiko Tamakoshi3,
  5. Hiroshi Satoh4,
  6. Kazuo Tajima5,
  7. Takaichiro Suzuki6,
  8. Tomotaka Sobue7
  1. 1Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan
  2. 2Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan
  3. 3Department of Public Health, Aichi Medical University School of Medicine, Nagoya, Japan
  4. 4Environmental Health Sciences, Tohoku University Graduate School of Medicine, Miyagi, Japan
  5. 5Aichi Cancer Center Research Institute, Nagoya, Japan
  6. 6Department of Cancer Control and Statistics, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
  7. 7Cancer Information Services and Surveillance Division, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan
  1. Correspondence to Dr Hiroyasu Iso, Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-9871, Japan; iso{at}


Objectives To estimate the gender-specific risk of mortality from cardiovascular disease according to smoking status and time since smoking cessation among former smokers in Japan.

Design Prospective study.

Setting 140 026 males and 156 810 females aged 40–79 years who participated in one of three cohort studies conducted in Japan between 1980 and 1990.

Outcome The gender-specific hazard ratios (HRs) for cardiovascular disease mortality were calculated after adjustment for age and cohort.

Results The age-adjusted and cohort-adjusted HRs for current smokers compared with lifelong non-smokers were 1.51 (95% CI 1.38 to 1.64) for total cardiovascular diseases, 2.19 (95% CI 1.79 to 2.67) for coronary heart disease and 1.24 (95% CI 1.10 to 1.41) for total stroke in males, and were 1.85 (95% CI 1.65 to 2.06), 2.84 (95% CI 2.24 to 3.60) and 1.70 (95% CI 1.44 to 2.01), respectively, in females. The age-adjusted and cohort-adjusted HRs for former smokers compared with current smokers according to the time period since smoking cessation decreased by approximately 5 years after smoking cessation and reached the same level as lifelong non-smokers approximately 10 years after smoking cessation among both males and females.

Conclusions The present study confirmed the association between smoking and mortality from cardiovascular disease in both males and females. Smoking cessation is a crucial preventive measure against death from cardiovascular disease.

  • Smoking
  • smoking cessation
  • cardiovascular disease
  • mortality
  • Japan
  • cessation
  • smoking caused disease

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  • Funding This work was supported by grants-in–aid for the Comprehensive Research on Cardiovascular Diseases, for Cancer Research and for the Third-Term Comprehensive Ten-Year Strategy for Cancer Control from the Ministry of Health, Labour, and Welfare, Japan and also by grants-in-aid for Scientific Research on Priority Areas from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the human ethics review committees of the National Cancer Center.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.