International Journal of Epidemiology, Vol 26, 1214-1218, Copyright © 1997 by International Epidemiological Association
E Prescott, M Osler, PK Andersen, A Bjerg, HO Hein, K Borch-Johnsen, P Lange, P Schnohr and J Vestbo
BACKGROUND: Two recent much cited publications have raised the concern that
risk associated with cigarette smoking has so far been underestimated. In
this study we wish to determine whether excess all- cause mortality
associated with smoking has increased during the last 20-30 years in a
study population representative of the general Danish population and
whether any such changes relate to changes in smoking behaviour. METHODS:
Pooled data from three prospective population studies conducted in
Copenhagen with detailed information on smoking habits. A total of 31,194
subjects, 17,669 males and 13,525 females, initially examined between 1964
and 1992 with examinations repeated at intervals from 1-10 years, were
followed until 1995 for all-cause mortality. Relative mortality risk in
smokers versus never-smokers was calculated within periods of five calendar
years and compared throughout the study period. RESULTS: Male smokers'
exposure did not change during the study period whereas female smokers'
exposure to tobacco increased in terms of age at smoking onset, quantity
smoked and depth of inhalation. During follow-up 5744 males and 2900
females died. In males, death rate ratios (comparing continuous smokers
with never- smokers) did not change in the study period. In females, ratios
increased from 1964-1978 to 1979-1994 by a factor of 1.3 (95% confidence
interval 1.0-1.8). CONCLUSIONS: In agreement with the observed changes in
smoking habits, excess mortality in male smokers did not increase whereas
excess mortality in female smokers increased slightly.
ARTICLES
Has risk associated with smoking increased? Results from the Copenhagen Center for Prospective Population Studies
Institute of Preventive Medicine, Kommunehospitalet, Copenhagen, Denmark.
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