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  • BMJ  (2)
  • Chia, Kee Seng  (2)
  • 1
    In: Tobacco Control, BMJ, Vol. 30, No. 3 ( 2021-05), p. 328-335
    Abstract: Little is known about the health harms associated with low-intensity smoking in Asians who, on average, smoke fewer cigarettes and start smoking at a later age than their Western counterparts. Methods In this pooled analysis of 738 013 Asians from 16 prospective cohorts, we quantified the associations of low-intensity ( 〈 5 cigarettes/day) and late initiation (≥35 years) of smoking with mortality outcomes. HRs and 95% CIs were estimated for each cohort by Cox regression. Cohort-specific HRs were pooled using random-effects meta-analysis. Findings During a mean follow-up of 11.3 years, 92 068 deaths were ascertained. Compared with never smokers, current smokers who consumed 〈 5 cigarettes/day or started smoking after age 35 years had a 16%–41% increased risk of all-cause, cardiovascular disease (CVD), respiratory disease mortality and a 〉 twofold risk of lung cancer mortality. Furthermore, current smokers who started smoking after age 35 and smoked 〈 5 cigarettes/day had significantly elevated risks of all-cause (HRs (95% CIs)=1.14 (1.05 to 1.23)), CVD (1.27 (1.08 to 1.49)) and respiratory disease (1.54 (1.17 to 2.01)) mortality. Even smokers who smoked 〈 5 cigarettes/day but quit smoking before the age of 45 years had a 16% elevated risk of all-cause mortality; however, the risk declined further with increasing duration of abstinence. Conclusions Our study showed that smokers who smoked a small number of cigarettes or started smoking later in life also experienced significantly elevated all-cause and major cause-specific mortality but benefited from cessation. There is no safe way to smoke—not smoking is always the best choice.
    Type of Medium: Online Resource
    ISSN: 0964-4563 , 1468-3318
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2010882-5
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  • 2
    In: BMJ Open, BMJ, Vol. 9, No. 8 ( 2019-08), p. e026225-
    Abstract: To study the association of educational level and risk of death from all causes, cardiovascular disease (CVD) and cancer among Asian populations. Design A pooled analysis of 15 population-based cohort studies. Setting and participants 694 434 Asian individuals from 15 prospective cohorts within the Asia Cohort Consortium. Interventions None. Main outcome measures HRs and 95% CIs for all-cause mortality, as well as for CVD-specific mortality and cancer-specific mortality. Results A total of 694 434 participants (mean age at baseline=53.2 years) were included in the analysis. During a mean follow-up period of 12.5 years, 103 023 deaths were observed, among which 33 939 were due to cancer and 34 645 were due to CVD. Higher educational levels were significantly associated with lower risk of death from all causes compared with a low educational level (≤primary education); HRs and 95% CIs for secondary education, trade/technical education and ≥university education were 0.88 (0.85 to 0.92), 0.81 (0.73 to 0.90) and 0.71 (0.63 to 0.80), respectively (p trend =0.002). Similarly, HRs (95% CIs) were 0.93 (0.89 to 0.97), 0.86 (0.78 to 0.94) and 0.81 (0.73 to 0.89) for cancer death, and 0.88 (0.83 to 0.93), 0.77 (0.66 to 0.91) and 0.67 (0.58 to 0.77) for CVD death with increasing levels of education (both p trend 〈 0.01). The pattern of the association among East Asians and South Asians was similar compared with ≤primary education; HR (95% CI) for all-cause mortality associated with ≥university education was 0.72 (0.63 to 0.81) among 539 724 East Asians (Chinese, Japanese and Korean) and 0.61 (0.54 to 0.69) among 154 710 South Asians (Indians and Bangladeshis). Conclusion Higher educational level was associated with substantially lower risk of death among Asian populations.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    Language: English
    Publisher: BMJ
    Publication Date: 2019
    detail.hit.zdb_id: 2599832-8
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