title: Smoking decreases the duration of life lived with and without cardiovascular disease: a life course analysis of the Framingham Heart Study.
abstract: OBJECTIVE
  To compare the burden of cardiovascular disease in terms of lifetime risk and life years lived with disease between smokers and non-smokers.
  
  
  RESULTS
  We constructed multi-state life tables describing transitions through various cardiovascular diseases for 4723 smokers and non-smokers observed during 20 biannual observations in the Original Framingham Heart Study. Non-smokers live 8.66 (95% CI 7.61-9.63) (men) and 7.59 (95% CI 6.33-8.92) (women) years longer than smokers and more years free of cardiovascular disease: 6.22 (95% CI 5.09-7.30) years for males and 4.93 (95% CI 3.54-6.29) for females. But non-smokers spend more years with cardiovascular disease over the life course: 2.43 (95% CI 1.72-3.16) years for males and 2.66 (95% CI 1.87-3.38) years for females. The risk of cardiovascular disease before age 70 is higher among smokers, but over the entire lifecourse male non-smokers have higher risks of coronary heart disease, myocardial infarction, stroke and congestive heart failure, and female non-smokers have higher risks of coronary heart disease and congestive heart failure.
  
  
  CONCLUSIONS
  Smoking, by shortening life, decreases both the probability and duration of cardiovascular disease throughout the life course. Non-smokers live many years longer and longer free of cardiovascular disease than smokers, but at the end of their life non-smokers will have lived longer with cardiovascular disease.
authors.affiliation: University of Groningen, Groningen, The Netherlands. mamun@sph.uq.edu.au
authors.forename: Abdullah Al
authors.initials: AA
authors.lastname: Mamun
authors.forename: Anna
authors.initials: A
authors.lastname: Peeters
authors.forename: Jan
authors.initials: J
authors.lastname: Barendregt
authors.forename: Frans
authors.initials: F
authors.lastname: Willekens
authors.forename: Wilma
authors.initials: W
authors.lastname: Nusselder
authors.forename: Luc
authors.initials: L
authors.lastname: Bonneux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000401:mortality*