Korean J Epidemiol.  2005 Jun;27(1):182-190.

Smoking and cause of death in Korea: 11 years follow-up prospective study

Affiliations
  • 1Graduate School of Public Health, Yonsei University, Seoul, Korea. jsunha@yumc.yonsei.ac.kr
  • 2Institute for Health Promotion, Yonsei University, Seoul, Korea.
  • 3National Institute of Health, Seoul, Korea.
  • 4National Health Insurance Corporation, Seoul, Korea.
  • 5Korea Institute of Oriental Medicine, Seoul, Korea.
  • 6Johns Hopkins Bloomberg School of Public Health, Baltimore, USA.

Abstract


OBJECTIVE
In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. METHOD: A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers.
RESULTS
In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36).
CONCLUSION
In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.

Keyword

All causes; cardiovascular disease; cancer; smoking; mortality

MeSH Terms

Alcohol Drinking
Bile Ducts
Cardiovascular Diseases
Cause of Death*
Cohort Studies
Esophagus
Female
Follow-Up Studies*
Humans
Insurance
Korea*
Larynx
Leukemia
Liver
Lung Neoplasms
Male
Mortality
Obesity
Outcome Assessment (Health Care)
Pancreas
Prevalence
Proportional Hazards Models
Prospective Studies*
Risk Factors
Smoke*
Smoking*
Stomach
Tobacco
Tobacco Products
Urinary Bladder
Surveys and Questionnaires
Smoke
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