Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts

Wei Zheng, Dale F. McLerran, Betsy A. Rolland, Zhenming Fu, Paolo Boffetta, Jiang He, Prakash Chandra Gupta, Kunnambath Ramadas, Shoichiro Tsugane, Fujiko Irie, Akiko Tamakoshi, Yu Tang Gao, Woon Puay Koh, Xiao Ou Shu, Kotaro Ozasa, Yoshikazu Nishino, Ichiro Tsuji, Hideo Tanaka, Chien Jen Chen, Jian Min YuanYoon Ok Ahn, Keun Young Yoo, Habibul Ahsan, Wen Harn Pan, You Lin Qiao, Dongfeng Gu, Mangesh Suryakant Pednekar, Catherine Sauvaget, Norie Sawada, Toshimi Sairenchi, Gong Yang, Renwei Wang, Yong Bing Xiang, Waka Ohishi, Masako Kakizaki, Takashi Watanabe, Isao Oze, San Lin You, Yumi Sugawara, Lesley M. Butler, Dong Hyun Kim, Sue K. Park, Faruque Parvez, Shao Yuan Chuang, Jin Hu Fan, Chen Yang Shen, Yu Chen, Eric J. Grant, Jung Eun Lee, Rashmi Sinha, Keitaro Matsuo, Mark Thornquist, Manami Inoue, Ziding Feng, Daehee Kang, John D. Potter

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.

Original languageEnglish
Article numbere1001631
JournalPLoS Medicine
Volume11
Issue number4
DOIs
Publication statusPublished - 04-2014

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Cohort Studies
Smoking
Mortality
Lung Neoplasms
Republic of Korea
Bangladesh
Singapore
Taiwan
India
Cause of Death
China
Japan
Cardiovascular Diseases
Confidence Intervals
Population

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Zheng, Wei ; McLerran, Dale F. ; Rolland, Betsy A. ; Fu, Zhenming ; Boffetta, Paolo ; He, Jiang ; Gupta, Prakash Chandra ; Ramadas, Kunnambath ; Tsugane, Shoichiro ; Irie, Fujiko ; Tamakoshi, Akiko ; Gao, Yu Tang ; Koh, Woon Puay ; Shu, Xiao Ou ; Ozasa, Kotaro ; Nishino, Yoshikazu ; Tsuji, Ichiro ; Tanaka, Hideo ; Chen, Chien Jen ; Yuan, Jian Min ; Ahn, Yoon Ok ; Yoo, Keun Young ; Ahsan, Habibul ; Pan, Wen Harn ; Qiao, You Lin ; Gu, Dongfeng ; Pednekar, Mangesh Suryakant ; Sauvaget, Catherine ; Sawada, Norie ; Sairenchi, Toshimi ; Yang, Gong ; Wang, Renwei ; Xiang, Yong Bing ; Ohishi, Waka ; Kakizaki, Masako ; Watanabe, Takashi ; Oze, Isao ; You, San Lin ; Sugawara, Yumi ; Butler, Lesley M. ; Kim, Dong Hyun ; Park, Sue K. ; Parvez, Faruque ; Chuang, Shao Yuan ; Fan, Jin Hu ; Shen, Chen Yang ; Chen, Yu ; Grant, Eric J. ; Lee, Jung Eun ; Sinha, Rashmi ; Matsuo, Keitaro ; Thornquist, Mark ; Inoue, Manami ; Feng, Ziding ; Kang, Daehee ; Potter, John D. / Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia : A Pooled Analysis of 21 Cohorts. In: PLoS Medicine. 2014 ; Vol. 11, No. 4.
@article{5611e65e901341f19bc3212bf33a5ecb,
title = "Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts",
abstract = "Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95{\%} confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71{\%} of Asia's total population. An approximately 1.44-fold (95{\%} CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8{\%} (95{\%} CI = 14.3{\%}-17.2{\%}) and 3.3{\%} (2.6{\%}-4.0{\%}) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95{\%} CI = 1,398,000-1,744,700). Among men, approximately 11.4{\%}, 30.5{\%}, and 19.8{\%} of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7{\%}, 4.6{\%}, and 1.7{\%}, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5{\%} and 16.7{\%} of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.",
author = "Wei Zheng and McLerran, {Dale F.} and Rolland, {Betsy A.} and Zhenming Fu and Paolo Boffetta and Jiang He and Gupta, {Prakash Chandra} and Kunnambath Ramadas and Shoichiro Tsugane and Fujiko Irie and Akiko Tamakoshi and Gao, {Yu Tang} and Koh, {Woon Puay} and Shu, {Xiao Ou} and Kotaro Ozasa and Yoshikazu Nishino and Ichiro Tsuji and Hideo Tanaka and Chen, {Chien Jen} and Yuan, {Jian Min} and Ahn, {Yoon Ok} and Yoo, {Keun Young} and Habibul Ahsan and Pan, {Wen Harn} and Qiao, {You Lin} and Dongfeng Gu and Pednekar, {Mangesh Suryakant} and Catherine Sauvaget and Norie Sawada and Toshimi Sairenchi and Gong Yang and Renwei Wang and Xiang, {Yong Bing} and Waka Ohishi and Masako Kakizaki and Takashi Watanabe and Isao Oze and You, {San Lin} and Yumi Sugawara and Butler, {Lesley M.} and Kim, {Dong Hyun} and Park, {Sue K.} and Faruque Parvez and Chuang, {Shao Yuan} and Fan, {Jin Hu} and Shen, {Chen Yang} and Yu Chen and Grant, {Eric J.} and Lee, {Jung Eun} and Rashmi Sinha and Keitaro Matsuo and Mark Thornquist and Manami Inoue and Ziding Feng and Daehee Kang and Potter, {John D.}",
year = "2014",
month = "4",
doi = "10.1371/journal.pmed.1001631",
language = "English",
volume = "11",
journal = "PLoS Medicine",
issn = "1549-1277",
publisher = "Public Library of Science",
number = "4",

}

Zheng, W, McLerran, DF, Rolland, BA, Fu, Z, Boffetta, P, He, J, Gupta, PC, Ramadas, K, Tsugane, S, Irie, F, Tamakoshi, A, Gao, YT, Koh, WP, Shu, XO, Ozasa, K, Nishino, Y, Tsuji, I, Tanaka, H, Chen, CJ, Yuan, JM, Ahn, YO, Yoo, KY, Ahsan, H, Pan, WH, Qiao, YL, Gu, D, Pednekar, MS, Sauvaget, C, Sawada, N, Sairenchi, T, Yang, G, Wang, R, Xiang, YB, Ohishi, W, Kakizaki, M, Watanabe, T, Oze, I, You, SL, Sugawara, Y, Butler, LM, Kim, DH, Park, SK, Parvez, F, Chuang, SY, Fan, JH, Shen, CY, Chen, Y, Grant, EJ, Lee, JE, Sinha, R, Matsuo, K, Thornquist, M, Inoue, M, Feng, Z, Kang, D & Potter, JD 2014, 'Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts', PLoS Medicine, vol. 11, no. 4, e1001631. https://doi.org/10.1371/journal.pmed.1001631

Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia : A Pooled Analysis of 21 Cohorts. / Zheng, Wei; McLerran, Dale F.; Rolland, Betsy A.; Fu, Zhenming; Boffetta, Paolo; He, Jiang; Gupta, Prakash Chandra; Ramadas, Kunnambath; Tsugane, Shoichiro; Irie, Fujiko; Tamakoshi, Akiko; Gao, Yu Tang; Koh, Woon Puay; Shu, Xiao Ou; Ozasa, Kotaro; Nishino, Yoshikazu; Tsuji, Ichiro; Tanaka, Hideo; Chen, Chien Jen; Yuan, Jian Min; Ahn, Yoon Ok; Yoo, Keun Young; Ahsan, Habibul; Pan, Wen Harn; Qiao, You Lin; Gu, Dongfeng; Pednekar, Mangesh Suryakant; Sauvaget, Catherine; Sawada, Norie; Sairenchi, Toshimi; Yang, Gong; Wang, Renwei; Xiang, Yong Bing; Ohishi, Waka; Kakizaki, Masako; Watanabe, Takashi; Oze, Isao; You, San Lin; Sugawara, Yumi; Butler, Lesley M.; Kim, Dong Hyun; Park, Sue K.; Parvez, Faruque; Chuang, Shao Yuan; Fan, Jin Hu; Shen, Chen Yang; Chen, Yu; Grant, Eric J.; Lee, Jung Eun; Sinha, Rashmi; Matsuo, Keitaro; Thornquist, Mark; Inoue, Manami; Feng, Ziding; Kang, Daehee; Potter, John D.

In: PLoS Medicine, Vol. 11, No. 4, e1001631, 04.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia

T2 - A Pooled Analysis of 21 Cohorts

AU - Zheng, Wei

AU - McLerran, Dale F.

AU - Rolland, Betsy A.

AU - Fu, Zhenming

AU - Boffetta, Paolo

AU - He, Jiang

AU - Gupta, Prakash Chandra

AU - Ramadas, Kunnambath

AU - Tsugane, Shoichiro

AU - Irie, Fujiko

AU - Tamakoshi, Akiko

AU - Gao, Yu Tang

AU - Koh, Woon Puay

AU - Shu, Xiao Ou

AU - Ozasa, Kotaro

AU - Nishino, Yoshikazu

AU - Tsuji, Ichiro

AU - Tanaka, Hideo

AU - Chen, Chien Jen

AU - Yuan, Jian Min

AU - Ahn, Yoon Ok

AU - Yoo, Keun Young

AU - Ahsan, Habibul

AU - Pan, Wen Harn

AU - Qiao, You Lin

AU - Gu, Dongfeng

AU - Pednekar, Mangesh Suryakant

AU - Sauvaget, Catherine

AU - Sawada, Norie

AU - Sairenchi, Toshimi

AU - Yang, Gong

AU - Wang, Renwei

AU - Xiang, Yong Bing

AU - Ohishi, Waka

AU - Kakizaki, Masako

AU - Watanabe, Takashi

AU - Oze, Isao

AU - You, San Lin

AU - Sugawara, Yumi

AU - Butler, Lesley M.

AU - Kim, Dong Hyun

AU - Park, Sue K.

AU - Parvez, Faruque

AU - Chuang, Shao Yuan

AU - Fan, Jin Hu

AU - Shen, Chen Yang

AU - Chen, Yu

AU - Grant, Eric J.

AU - Lee, Jung Eun

AU - Sinha, Rashmi

AU - Matsuo, Keitaro

AU - Thornquist, Mark

AU - Inoue, Manami

AU - Feng, Ziding

AU - Kang, Daehee

AU - Potter, John D.

PY - 2014/4

Y1 - 2014/4

N2 - Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.

AB - Background:Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.Methods and Findings:We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: A 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.Conclusions:Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.Please see later in the article for the Editors' Summary.

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