title: Smoking behavioral changes and subsequent mortality during a 18-year follow-up in Kinmen, Taiwan.
abstract: BACKGROUND
  The aim of this study was to examine the changes in smoking behavior over 6 years and to relate these changes to mortality risk during 18 years' follow-up.
  
  
  METHODS
  We followed a cohort for 6 years (1991-1997) to assess changes in smoking behavior and then for an additional 12 years (1997-2008) to relate these findings to mortality in 4986 Chinese individuals. Participants were classified as never smokers, long-term quitters, new smokers, new quitters, and continuing smokers. Mortality was ascertained by linkage with the nationwide death registry.
  
  
  RESULTS
  Compared with never smokers, continuing smokers had the highest risk of 1.84 [95% confidence interval (CI): 1.38, 2.45] for all-cause mortality, new quitters had a risk of 1.49 (95% CI: 1.04, 2.15), new smokers had a risk of 1.26 (95% CI: 0.59, 2.68), and long-term quitters had a risk of 1.11 (95% CI: 0.64, 1.91). There was a significant 19% risk reduction in all-cause mortality for new quitters.
  
  
  CONCLUSIONS
  Smoking cessation was associated with a significant reduction in mortality risk within approximately 6 years, while no significantly increased risk was observed for long-term quitters.
authors.affiliation: Kin-Men Hospital, Ministry of Health and Welfare, Kin-Men, Taiwan, ROC; Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
authors.forename: Yen-Huai
authors.initials: YH
authors.lastname: Lin
authors.affiliation: Graduate Institute of Sports and Health, National Changhua University of Education, Changhua, Taiwan, ROC.
authors.forename: Po-Wen
authors.initials: PW
authors.lastname: Ku
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei, Taiwan, ROC. Electronic address: pschou@ym.edu.tw.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012907:Smoking / Q000401:mortality* / Q000523:psychology; D016540:Smoking Cessation
keywords: Chinese; mortality; repeated assessment; smoking; smoking behavior