American Journal of Epidemiology Advance Access originally published online on March 16, 2007
American Journal of Epidemiology 2007 165(11):1280-1286; doi:10.1093/aje/kwm002
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ORIGINAL CONTRIBUTIONS |
Impact of Smoking and Smoking Cessation on Lung Cancer Mortality in the Asia-Pacific Region
1 Nutrition and Lifestyle Division, The George Institute for International Health, University of Sydney, Sydney, Australia
2 Division of Health Systems, Policy and Practice, University of Queensland, Brisbane, Australia
3 Department of Community Medicine, University of Hong Kong, Hong Kong, People's Republic of China
4 Guangzhou Occupational Diseases Prevention and Treatment Centre, Guangzhou, People's Republic of China
5 Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, Seoul, Korea
Correspondence to Dr. Rachel Huxley, The George Institute for International Health, P.O. Box M201, Missenden Road, Sydney, New South Wales 2050, Australia (e-mail: rhuxley{at}george.org.au).
Received for publication April 24, 2006. Accepted for publication November 17, 2006.
Cigarette smoking is becoming increasingly common in Asia while quitting remains rare, in part because of a lack of knowledge about the risks of smoking. This study compared the risk of death from lung cancer associated with smoking habits in Australia and New Zealand and in Asia by using data from the Asia Pacific Cohort Studies Collaboration: 31 studies involving 480,125 individuals. Cox regression models were used. The hazard ratios for lung cancer mortality associated with current smoking were, for men, 2.48 (95% confidence interval (CI): 1.99, 3.11) in Asia versus 9.87 (95% CI: 6.04, 16.12) in Australia and New Zealand; p for homogeneity <0.0001. For women, the corresponding estimates were 2.35 (95% CI: 1.29, 4.28) in Asia versus 19.33 (95% CI: 10.0, 37.3) in Australia and New Zealand; p for homogeneity <0.0001. Quitting was beneficial in both regions; the hazard ratios for former compared with current smokers were 0.69 (95% CI: 0.53, 0.92) in Asia and 0.30 (95% CI: 0.22, 0.41) in Australia and New Zealand. The lesser effect in Asia was partly explained by the fewer number of cigarettes smoked and the shorter duration of follow-up in Asian studies. These results suggest that tobacco control policies in Asia should not solely concentrate on preventing the uptake of smoking but also attend to cessation.
Asia; lung neoplasms; mortality; smoking; smoking cessation
Abbreviations: ANZ, Australia and New Zealand; APCSC, Asia Pacific Cohort Studies Collaboration; CI, confidence interval
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  F Barzi, R Huxley, K Jamrozik, T-H Lam, H Ueshima, D Gu, H C Kim, and M Woodward Association of smoking and smoking cessation with major causes of mortality in the Asia Pacific Region: the Asia Pacific Cohort Studies Collaboration Tob. Control, June 1, 2008; 17(3): 166 - 172. [Abstract] [Full Text] [PDF]
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