Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Smoking Cessation and Mortality from Cardiovascular Disease among Japanese Men and Women
The JACC Study
1 Department of Public Health Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba-shi, Japan.
2 Department of Nutrition and Food Sciences, Mukogawa Women’s University, Nishinomiya-shi, Japan.
3 Infectious Disease Research Division, Hyogo Prefectural Institute of Public Health and Environmental Sciences, Kobe, Japan.
4 Department of Public Health/Health Information Dynamics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
5 Department of Social Medicine and Cultural Sciences, Research Institute for Neurological Diseases and Geriatrics, Kyoto Prefectural University of Medicine, Kyoto, Japan.
6 Department of Public Health, Aichi Medical University, Wakayama, Japan.
7 Department of Health and Environmental Sciences, Kyoto University, Kyoto, Japan.
8 Department of Hygiene, Hyogo College of Medicine, Hyogo, Japan.
9 Department of Public Health, Juntendo Medical University, Tokyo, Japan.
10 Department of Preventive Medicine/Biostatistics and Medical Decision Making, Nagoya University Graduate School of Medicine, Nagoya, Japan.
To examine the effect of smoking cessation on cardiovascular disease mortality in Asians, the authors conducted a 10-year prospective cohort study of 94,683 Japanese (41,782 men and 52,901 women) aged 40–79 years who were part of the Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study). During 941,043 person-years of follow-up between 1989–1990 and 1999, 698 deaths from stroke, 348 from coronary heart disease, and 1,555 from total cardiovascular disease occurred in men and 550, 199, and 1,155, respectively, in women. For men, the multivariate relative risks for current smokers compared with never smokers were 1.39 (95% confidence interval (CI): 1.13, 1.70) for stroke, 2.51 (95% CI: 1.79, 3.51) for coronary heart disease, and 1.60 (95% CI: 1.39, 1.84) for total cardiovascular disease. The respective relative risks for women were 1.65 (95% CI: 1.21, 2.25), 3.35 (95% CI: 2.23, 5.02), and 2.06 (95% CI: 1.69, 2.51), with larger excess risks for persons aged 40–64 years than for older persons. The risk decline after smoking cessation occurred for coronary heart disease and total cardiovascular disease within 2 years and for total stroke after 2–4 years. For each endpoint and in both age subgroups of 40–64 and 65–79 years, most of the benefit of cessation occurred after 10–14 years following cessation. Findings imply the importance of smoking cessation at any age to prevent cardiovascular disease in Japanese.
cerebrovascular accident; coronary disease; follow-up studies; mortality; smoking cessation
Abbreviations: CI, confidence interval; ICD-9, International Classification of Diseases, Ninth Revision; ICD-10, International Classification of Diseases, Tenth Revision; JACC Study, Japan Collaborative Cohort Study for Evaluation of Cancer Risk.
Reprint requests to Dr. Hiroyasu Iso, Department of Public Health Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba-shi, Ibaraki-ken 305-3585, Japan (e-mail: fvgh5640{at}mb.infoweb.ne.jp).
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