Smoking, quitting and mortality in an elderly cohort of 56,000 Hong Kong Chinese.
BACKGROUND
Although the harms of smoking are well established, it is unclear how they extend into old age in the Chinese.


OBJECTIVE
To examine the relationship of smoking with all-cause and major cause-specific mortality in elderly Chinese men and women, respectively, in Hong Kong.


METHODS
Mortality by smoking status was examined in a prospective cohort study of 56,167 (18,749 men, 37,416 women) Chinese aged > or = 65 years enrolled from 1998 to 2000 at all the 18 elderly health centres of the Hong Kong Government Department of Health.


RESULTS
After a mean follow-up of 4.1 years, 1848 male and 2035 female deaths occurred among 54,214 subjects (96.5% successful follow-up). At baseline, more men than women were current smokers (20.3% vs 4.0%) and former smokers (40.8% vs 7.9%). The adjusted RRs (95% CI) for all-cause mortality in former and current smokers, compared with never smokers, were 1.39 (1.23 to 1.56) and 1.75 (1.53 to 2.00) in men and 1.43 (1.25 to 1.64) and 1.38 (1.14 to 1.68) in women, respectively. For current smokers, the RRs (95% CI) for all-cause mortality were 1.59 (1.39 to 1.82), 1.72 (1.48 to 2.00) and 1.84 (1.43 to 2.35) for daily consumption of 1-9, 10-20 and > 21 cigarettes, respectively (p for trend <0.001). RRs (95% CI) were 1.49 (1.30 to 1.72) and 2.20 (1.88 to 2.57) in former and current smokers for all deaths from cancer, and 1.24 (1.04 to 1.47) and 1.57 (1.28 to 1.94) for all cardiovascular deaths, respectively. Quitters had significantly lower risks of death than current smokers from all causes, lung cancer, all cancers, stroke and all cardiovascular diseases.


CONCLUSIONS
In old age, smoking continues to be a major cause of death, and quitting is beneficial. Smoking cessation is urgently needed in rapidly ageing populations in the East.
Lam
Tai Hing
TH
Department of Community Medicine, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong. commed@hkucc.hku.hk
Li
Zhi Bin
ZB
Ho
Sai Yin
SY
Chan
Wai Man
WM
Ho
Kin Sang
KS
Tham
May Ked
MK
Cowling
Benjamin J
BJ
Schooling
C Mary
CM
Leung
Gabriel M
GM
D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health / Q000208:ethnology; D002423:Cause of Death; D015331:Cohort Studies; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000401:mortality; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000401:mortality*; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology