title: Association between smoking and mortality: Khon Kaen cohort study, Thailand.
abstract: BACKGROUND
  Despite anti-smoking campaigns, smoking prevalence among Thai males aged 30 or older is high, at around 50%. The purpose of this study was to determine the relationship between smoking and mortality in a rural Thai community.
  
  
  METHODS
  Subjects enrolled into the Khon Kaen cohort study between 1990 and 2001 were followed up for their vital status until 16th March 2012. The death resource was from the Bureau of Policy and Strategy, Ministry of Interior, Thailand. A Cox proportional hazards model was used to analyse the association between smoking and death, controlling for age, education level and alcohol drinking, and confidence intervals were calculated using the floating risk method.
  
  
  RESULTS
  The study recruited 5,962 male subjects, of whom 1,396 died during a median 13.5 years of follow-up. Current smokers were more likely to die than never smokers after controlling for age, education level and alcohol drinking (HR, 95%CI: 1.41, 1.32- 1.51), and the excess mortality was greatest for lung cancer (HR, 95%CI: 3.51, 2.65-4.66). However, there was no increased risk with increasing dose of tobacco, and no difference in risk between smokers of yamuan (hand- rolled cigarettes) and manufactured tobacco.
  
  
  CONCLUSIONS
  Mortality from cancer, particularly lung cancer, and from all causes combined is dependent on smoking status among men in rural Thailand, but the relative risks are lower than have been reported from studies in high income countries, where the tobacco epidemic is more established.
authors.affiliation: Department of Biostatistics and Demography, Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand.
authors.forename: Siriporn
authors.initials: S
authors.lastname: Kamsa-Ard
authors.forename: Supannee
authors.initials: S
authors.lastname: Promthet
authors.forename: Sarah
authors.initials: S
authors.lastname: Lewington
authors.forename: Julie Ann
authors.initials: JA
authors.lastname: Burrett
authors.forename: Paul
authors.initials: P
authors.lastname: Sherliker
authors.forename: Supot
authors.initials: S
authors.lastname: Kamsa-Ard
authors.forename: Surapon
authors.initials: S
authors.lastname: Wiangnon
authors.forename: Donald Maxwell
authors.initials: DM
authors.lastname: Parkin
mesh_terms: D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology / Q000401:mortality*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology / Q000401:mortality*; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology