| Titre : | Smoking Reduction at Midlife and Lifetime Mortality Risk in Men : A Prospective Cohort Study. (2012) |
| Auteurs : | Yariv GERBER ; Uri GOLDBOURT ; Vicki MYERS ; Department of Epidemiology and Preventive Medicine. School of Public Health. Sackler Faculty of Medicine. Tel Aviv University. Tel Aviv. ISR |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 175, n° 10, 2012) |
| Pagination : | 1006-1012 |
| Langues: | Anglais |
| Mots-clés : | Tabagisme ; Tabac ; Epidémiologie ; Mortalité ; Facteur risque ; Risque ; Homme ; Etude prospective ; Longévité ; Comportement |
| Résumé : | [BDSP. Notice produite par INIST-CNRS ABnR0xqn. Diffusion soumise à autorisation]. Previous studies have not shown a survival advantage for smoking reduction. The authors assessed survival and life expectancy according to changes in smoking intensity in a cohort of Israeli working men. Baseline smokers recruited in 1963 were reassessed in 1965 (n=4,633 ; mean age, 51 years) and followed up prospectively for mortality through 2005. Smoking intensity at both time points was self-reported and categorized as none, 1-10,11-20, and>21 cigarettes per day. Change between smoking categories was noted, and participants were classified as increased (8%), maintained (65%), reduced (17%), or quit (10%) smoking. During a median follow-up of 26 (quartiles 1-3 : 16-35) years, 87% of participants died. Changes in intensity were associated with survival. In multivariable-adjusted models, the hazard ratios for mortality were 1.14 (95% confidence interval (CI) : 0.99,1.32) among increasers, 0.85 (95% CI : 0.77,0.95) among reducers, and 0.78 (95% CI : 0.69,0.89) among quitters, compared with maintainers. Inversely, the adjusted odds ratios of surviving to age 80 years were 0.77 (95% CI : 0.60,0.98), 1.22 (95% CI : 1.01,1.47), and 1.33 (95% CI : 1.07,1.66), respectively. The survival benefit associated with smoking reduction was mostly evident among heavy smokers and for cardiovascular disease mortality. These results suggest that decreasing smoking intensity should be considered as a risk-reduction strategy for heavy smokers who cannot quit abruptly. |
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