In a nationally representative sample of 1.1 million homes, they
compared the prevalence
of smoking among 33,000 deceased women and 41,000 deceased
men (case
subjects) with the prevalence of smoking among 35,000 living
women and 43,000
living men (unmatched control subjects). Mortality risk
ratios comparing smokers with
nonsmokers were adjusted for age, educational level, and use
of alcohol.
Results
About 5% of female control subjects and 37% of male control
subjects between the
ages of 30 and 69 years were smokers. In this age group,
smoking was associated with
an increased risk of death from any medical cause among both
women (risk ratio, 2.0;
99% confidence interval [CI], 1.8 to 2.3) and men (risk
ratio, 1.7; 99% CI, 1.6 to 1.8).
Daily smoking of even a small amount of tobacco was
associated with increased mortality.
Excess deaths among smokers, as compared with nonsmokers,
were chiefly
from tuberculosis among both women (risk ratio, 3.0; 99% CI,
2.4 to 3.9) and men
(risk ratio, 2.3; 99% CI, 2.1 to 2.6) and from respiratory,
vascular, or neoplastic disease.
Smoking was associated with a reduction in median survival
of 8 years for
women (99% CI, 5 to 11) and 6 years for men (99% CI, 5 to
7). If these associations
are mainly causal, smoking in persons between the ages of 30
and 69 years is responsible
for about 1 in 20 deaths of women and 1 in 5 deaths of men.
In 2010, smoking
will cause about 930,000 adult deaths in India; of the dead,
about 70% (90,000 women
and 580,000 men) will be between the ages of 30 and 69
years. Because of population
growth, the absolute number of deaths in this age group is
rising by about 3%
per year.
Source NEJM
