The mortality risks of smokers in Taiwan: Part I: cause-specific mortality.
BACKGROUND
Few studies of adverse health effects from smoking have been conducted in southeastern Asian populations which may exhibit racial, cultural, and smoking behavioral differences that could affect mortality patterns. This study aims to quantify cause-specific mortality risks among cigarette smokers in Taiwan.


METHODS
The study population for this investigation was derived from two existing prospective study cohorts: a community-based cohort and a cohort composed of civil servants and teachers. Smoking data were obtained by face-to-face interview in the community cohort and by self-administered questionnaire in the civil servant/teacher cohort. The mortality risks of current smokers, adjusted for age, were compared to those of nonsmokers using Cox's proportional hazards model and dose-response relationships were examined by variables of smoking intensity and duration.


RESULTS
Male smokers had significantly higher all-cause mortality than nonsmokers. Cigarette smoking was also significantly associated with increased risks of dying from cancer, cardiovascular disease, respiratory disease, chronic bronchitis, diabetes, peptic ulcer, liver cirrhosis, and kidney disease. In addition, smokers had an increase in risk of fatal injuries from motor vehicle accidents and nonmotor vehicle accidents, as well as cancers of the oral cavity nasopharynx, esophagus, stomach, rectum, liver, and lungs. Risks for women smokers were generally higher than those for men, although this is based on small numbers of smokers. In women, deaths from all causes, all cancers, and cancers of the cervix, liver, and lung, cardiovascular disease, and respiratory disease were also significantly increased. The mean age at death for smokers who died before age 65 from smoking-related diseases was 57.4 years, which represented a loss of 22 years of life expectancy.


CONCLUSIONS
The pervasive and serious impact of cigarette smoking on the health of Taiwanese cannot be underestimated.
Division of Health Policy Research, National Health Research Institute, Taipei, Taiwan.
Chi-Pang
CP
Wen
Shan Pou
SP
Tsai
Chien-Jen
CJ
Chen
Ting-Yuan
TY
Cheng
D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012016:Reference Values; D018570:Risk Assessment; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality*; D013624:Taiwan / Q000453:epidemiology