title: Smoking status, sports participation and mortality from coronary heart disease.
abstract: BACKGROUND
  Since smoking and exercise have opposite effects on coronary risk factors, the hypothesis was proposed that smoking might weaken the protective effect of exercise on prevention of coronary heart disease.
  
  
  OBJECTIVE
  To determine the effect of smoking on the relationship between sports participation and mortality from coronary heart disease.
  
  
  METHODS
  Population-based prospective cohort study in Japan.
  
  
  METHODS
  A total of 76 832 Japanese men and women, aged 40-79 years with no history of stroke, coronary heart disease, or cancer, completed a self-administered questionnaire between 1988 and 1990.
  
  
  METHODS
  Systematic mortality surveillance was carried out through 2003, and 638 deaths from coronary heart disease (496 myocardial infarction) were identified.
  
  
  RESULTS
  People who reported the longest time in sports participation (>or=5 hours/week) had an approximately 50-80% lower age-adjusted risk of mortality from coronary heart disease compared with those in the second lowest category (1-2 hours/week) among never and ex-smokers, but no association was found among current smokers. Adjustment for known risk factors and exclusion of subjects who died within 2 years of the baseline inquiry did not substantially alter these associations. The multivariable hazard ratios (95% confidence interval) of coronary heart disease for the >or=5 hours/week versus 1-2 hours/week of sports participation were 0.44 (0.23 to 0.86) among never smokers, 0.18 (0.05 to 0.60) among ex-smokers, and 0.82 (0.47 to 1.40) among current smokers. Similar associations were found for men and women.
  
  
  CONCLUSIONS
  Smoking may reduce the beneficial effect of sports participation for reduction of fatal coronary heart disease.
authors.affiliation: Public Health, Department of Social and Environmental Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Shuita-shi, Osaka 565-0871 Japan.
authors.forename: H
authors.initials: H
authors.lastname: Noda
authors.forename: H
authors.initials: H
authors.lastname: Iso
authors.forename: H
authors.initials: H
authors.lastname: Toyoshima
authors.forename: C
authors.initials: C
authors.lastname: Date
authors.forename: A
authors.initials: A
authors.lastname: Yamamoto
authors.forename: S
authors.initials: S
authors.lastname: Kikuchi
authors.forename: A
authors.initials: A
authors.lastname: Koizumi
authors.forename: T
authors.initials: T
authors.lastname: Kondo
authors.forename: Y
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Wada
authors.forename: Y
authors.initials: Y
authors.lastname: Inaba
authors.forename: A
authors.initials: A
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000209:etiology / Q000401:mortality* / Q000517:prevention & control; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D013177:Sports / Q000706:statistics & numerical data*; D013997:Time Factors