Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies

Publication date: 10–16 October 2015 Source:The Lancet, Volume 386, Issue 10002 Author(s): Zhengming Chen, Richard Peto, Maigeng Zhou, Andri Iona, Margaret Smith, Ling Yang, Yu Guo, Yiping Chen, Zheng Bian, Garry Lancaster, Paul Sherliker, Shutao Pang, Hao Wang, Hua Su, Ming Wu, Xianping Wu, Junshi Chen, Rory Collins, Liming Li Background Chinese men now smoke more than a third of the world's cigarettes, following a large increase in urban then rural usage. Conversely, Chinese women now smoke far less than in previous generations. We assess the oppositely changing effects of tobacco on male and female mortality. Methods Two nationwide prospective studies 15 years apart recruited 220 000 men in about 1991 at ages 40–79 years (first study) and 210 000 men and 300 000 women in about 2006 at ages 35–74 years (second study), with follow-up during 1991–99 (mid-year 1995) and 2006–14 (mid-year 2010), respectively. Cox regression yielded sex-specific adjusted mortality rate ratios (RRs) comparing smokers (including any who had stopped because of illness, but not the other ex-smokers, who are described as having stopped by choice) versus never-smokers. Findings Two-thirds of the men smoked; there was little dependence of male smoking prevalence on age, but many smokers had not smoked cigarettes throughout adult life. Comparing men born before and since 1950, in the older generation, the age at which smoking had started was ...
Source: The Lancet - Category: Journals (General) Source Type: research