title: Smoking reduction, smoking cessation, and mortality: a 16-year follow-up of 19,732 men and women from The Copenhagen Centre for Prospective Population Studies.
abstract: The authors investigated the association between changes in smoking habits and mortality by pooling data from three large cohort studies conducted in Copenhagen, Denmark. The study included a total of 19,732 persons who had been examined between 1967 and 1988, with reexaminations at 5- to 10-year intervals and a mean follow-up of 15.5 years. Date of death and cause of death were obtained by record linkage with nationwide registers. By means of Cox proportional hazards models, heavy smokers (>or=15 cigarettes/day) who reduced their daily tobacco intake by at least 50% without quitting between the first two examinations and participants who quit smoking were compared with persons who continued to smoke heavily. After exclusion of deaths occurring in the first 2 years of follow-up, the authors found the following adjusted hazard ratios for subjects who reduced their smoking: for cardiovascular diseases, hazard ratio (HR) = 1.01 (95% confidence interval (CI): 0.76, 1.35); for respiratory diseases, HR = 1.20 (95% CI: 0.70, 2.07); for tobacco-related cancers, HR = 0.91 (95% CI: 0.63, 1.31); and for all-cause mortality, HR = 1.02 (95% CI: 0.89, 1.17). In subjects who stopped smoking, most estimates were significantly lower than the heavy smokers'. These results suggest that smoking reduction is not associated with a decrease in mortality from tobacco-related diseases. The data confirm that smoking cessation reduces mortality risk.
authors.affiliation: The Copenhagen Centre for Prospective Population Studies, Danish Epidemiology Science Centre at the Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark. ng@ipm.hosp.dk
authors.forename: Nina S
authors.initials: NS
authors.lastname: Godtfredsen
authors.forename: Claus
authors.initials: C
authors.lastname: Holst
authors.forename: Eva
authors.initials: E
authors.lastname: Prescott
authors.forename: Jørgen
authors.initials: J
authors.lastname: Vestbo
authors.forename: Merete
authors.initials: M
authors.lastname: Osler
mesh_terms: D002423:Cause of Death; D016001:Confidence Intervals; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D011446:Prospective Studies; D012042:Registries; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires