TY - JOUR
T1 - Smoking and All-cause Mortality in Older Adults
T2 - Results From the CHANCES Consortium
AU - Müezzinler, Aysel
AU - Mons, Ute
AU - Gellert, Carolin
AU - Schöttker, Ben
AU - Jansen, Eugène
AU - Kee, Frank
AU - O'Doherty, Mark G.
AU - Kuulasmaa, Kari
AU - Freedman, Neal D.
AU - Abnet, Christian C.
AU - Wolk, Alicja
AU - Håkansson, Niclas
AU - Orsini, Nicola
AU - Wilsgaard, Tom
AU - Bueno-De-Mesquita, Bas
AU - Van Der Schouw, Yvonne T.
AU - Peeters, Petra H.M.
AU - De Groot, Lisette C.P.G.M.
AU - Peters, Annette
AU - Orfanos, Philippos
AU - Linneberg, Allan
AU - Pisinger, Charlotta
AU - Tamosiunas, Abdonas
AU - Baceviciene, Migle
AU - Luksiene, Dalia
AU - Bernotiene, Gailute
AU - Jousilahti, Pekka
AU - Petterson-Kymmer, Ulrika
AU - Jansson, Jan Håkan
AU - Söderberg, Stefan
AU - Eriksson, Sture
AU - Jankovic, Nicole
AU - Sánchez, María José
AU - Veronesi, Giovanni
AU - Sans, Susana
AU - Drygas, Wojciech
AU - Trichopoulou, Antonia
AU - Boffetta, Paolo
AU - Brenner, Hermann
N1 - Publisher Copyright:
© 2015 American Journal of Preventive Medicine.
PY - 2015/11
Y1 - 2015/11
N2 - Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.
AB - Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.
UR - https://www.scopus.com/pages/publications/84938943218
U2 - 10.1016/j.amepre.2015.04.004
DO - 10.1016/j.amepre.2015.04.004
M3 - Article
C2 - 26188685
AN - SCOPUS:84938943218
SN - 0749-3797
VL - 49
SP - e53-e63
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 5
ER -