title: Impact of drinking and smoking habits on cerebrovascular disease risk among male employees.
abstract: We aimed to analyze the impact of drinking and smoking behavior on the risk of developing cerebrovascular diseases among male employees aged 20-46 years. Twenty years of follow-up data of male employees enrolled in the DENSO Health Insurance Program were used for analyses.
  
  
  
  Of 29,048 male employees aged 20-46 years who were enrolled in the insurance program in 1994, 25,084 (86.4%) employees underwent annual health check-ups until 2003 without missing an appointment. Of these 25,084 employees, the data of 11,784 (40.6%) employees who self-reported drinking and smoking habits were used for analyses. The hazard ratio and 95% confidence intervals (CIs) for developing cerebrovascular disease in 2004-2013 were calculated in four risk groups categorized as per drinking and smoking behavior in the young group who were in their 20s and the middle-aged group who were in their 30s-40s in 1994. Based on their drinking behavior, participants were categorized into two groups: "not drinking or drinking sometimes" and "drinking every day." Based on their smoking behavior, participants were also categorized into two groups: "not smoking for 10 years" and "smoking for 10 years."
  
  
  
  A Cox's proportional hazard model revealed that after controlling for body mass index, systolic blood pressure, triglycerides, total cholesterol, fasting plasma glucose, and age, the hazard ratios for "smoking and drinking every day" were 3.82 (95% CI: 1.40-10.41) in the young group and 2.31 (95% CI: 1.27-4.17) in the middle-aged group.
  
  
  
  Male employees who had been drinking and smoking for 10 years had a higher risk of developing cerebrovascular diseases. To prevent cerebrovascular diseases among male employees, it may be effective to offer behavior change interventions for both drinking and smoking habits, regardless of the age group.
authors.affiliation: DENSO Health Insurance Society.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Hatanaka
authors.forename: Keiko
authors.initials: K
authors.lastname: Shimokata
authors.forename: Shigeki
authors.initials: S
authors.lastname: Osugi
authors.forename: Noriyo
authors.initials: N
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D001521:Behavior Therapy; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D016016:Proportional Hazards Models; D012306:Risk; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D055815:Young Adult