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Smoking and mortality in a prospective cohort study of elderly C hinese in H ong K ong
Author(s) -
Lam Tai H.,
Xu Lin,
Schooling C. Mary,
Chan Wai M.,
Lee Siu Y.,
Leung Gabriel M.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12776
Subject(s) - prospective cohort study , medicine , cohort study , cohort , gerontology , demography , environmental health , sociology
Background and Aims Large cohort studies on smoking and mortality in elderly people are scarce, and few studies examined smokers aged 85+ years separately. We estimated the risks of all‐cause and cause‐specific mortality due to smoking in an elderly C hinese cohort in H ong K ong. Design A population‐based prospective cohort of 65 510 C hinese enrolled from 1998 to 2001 and followed until M ay 2012. Setting All 18 E lderly H ealth S ervice centres in H ong K ong, C hina. Participants Elderly people aged 65+ years. Measurements Self‐reported smoking status was assessed at baseline interview and categorized as never, former and current smokers. Findings Compared with never smokers, after adjustment for sex, age, education, social security assistance, housing type, monthly expenditure, alcohol use, depressive symptoms and health status, the hazard ratio ( HR ) for current smokers was 1.89 [95% confidence interval ( CI ) = 1.81–1.98] for all participants aged 65+ years at baseline, corresponding to an attributable fraction ( AF ) of about 50%, which is based on AF = ( HR ‐1)/ HR . As the effect of smoking varied with age ( P for age interaction <0.001), subgroup analysis by age group showed that the adjusted HR for current smokers aged 65–84 years was 1.93 (95% CI = 1.84–2.03), and for 85+ years was 1.29 (95% CI = 1.05–1.58). All the risk estimates did not vary by sex ( P for sex interaction ranged 0.74–0.89). Conclusions In H ong K ong, the risk of death from smoking appears to be the same for C hinese women as it is for men. Half of all deaths in C hinese smokers aged 65 years and older and a quarter of all deaths in C hinese smokers aged 85 years and older are caused by smoking‐attributable diseases.