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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 Iso2,*,
  3. Shoichiro Tsugane3,
  4. Akiko Tamakoshi4,
  5. Hiroshi Satoh5,
  6. Kazuo Tajima6,
  7. Takaichiro Suzuki7,
  8. Tomotaka Sobue3
  1. 1 Osaka University Graduate School of Medicine, Japan;
  2. 2 Osaka University, Graduate School of Medicine, Japan;
  3. 3 National Cancer Center, Japan;
  4. 4 Aichi Medical University, Japan;
  5. 5 Tohoku University, Japan;
  6. 6 Aichi Cancer Center Research Institute, Japan;
  7. 7 Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan
  1. Correspondence to: Hiroyasu Iso, Public Health, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, 565-0871, Japan; fvgh5640{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 to 79 years who participated in one of three cohort studies conducted in Japan between 1980 and 1990.

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

Results: The age-and cohort-adjusted hazard ratios for current smokers compared with lifelong nonsmokers were 1.51 (95%CI:1.38-1.64) for total cardiovascular diseases, 2.19 (95%CI:1.79-2.67) for coronary heart disease, and 1.24 (95%CI:1.01-1.41) for total stroke in males and were 1.85 (95%CI:1.65-2.06), 2.84 (95%CI:2.24-3.60), and 1.70 (95%CI:1.44-2.01), respectively, in females. The age-and cohort-adjusted hazard ratios 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 nonsmokers approximately 10 years after smoking cessation among both males and females.

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

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