Background: Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest.
Methods and Findings: We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged ≥45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan—accounting for ∼71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37–1.51) and 1.48-fold (1.38–1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%–17.2%) and 3.3% (2.6%–4.0%) of deaths, respectively, in men and women aged ≥45 y in the seven countries/regions combined, with a total number of estimated deaths of ∼1,575,500 (95% CI = 1,398,000–1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged ≥45 y.
Conclusions: Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged ≥45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented.
Title
Burden of Total and Cause-Specific Mortality Related to Tobacco Smoking among Adults Aged ≥45 Years in Asia: A Pooled Analysis of 21 Cohorts
Author
Zheng, Wei : Vanderbilt University
McLerran, Dale F. : Fred Hutchinson Cancer Research Center
Rolland, Betsy A. : Fred Hutchinson Cancer Research Center
Fu, Zhenming : Vanderbilt University
Boffetta, Paolo : Ichan School of Medicine at Mount Sinai
He, Jiang : Tulane University
Gupta, Prakash Chandra : Healis-Sekhsaria Institute for Public Health
Ramadas, Kunnambath : Regional Cancer Center
Tsugane, Shoichiro : National Cancer Center
Irie, Fujiko : Ibaraki Prefectural Government
Tamakoshi, Akiko : Aichi Medical University
Gao, Yu-Tang : Shanghai Cancer Institute
Koh, Woon-Puay : National University of Singapore
Shu, Xiao-Ou : Vanderbilt University
Ozasa, Kotaro : Radiation Effects Research Foundation
Nishino, Yoshikazu : Miyagi Cancer Center Research Institute
Tsuji, Ichiro : Tohoku University
Tanaka, Hideo : Tohoku University
Chen, Chien-Jen : National Taiwan University
Yuan, Jian-Min : University of Pittsburgh
Ahn, Yoon-Ok : Seoul National University
Yoo, Keun-Young : Seoul National University
Ahsan, Habibul : University of Chicago
Content Type
Article
Published in
PLOS Medicine
Funding Information
International Agency for Research on Cancer
Association for International Cancer Research
Cancer Research UK
National Institutes of Health, P42ES010349
National Institutes of Health, R01CA102484
National Institutes of Health, R01CA107431
American Heart Association, 9750612N
National Heart, Lung, and Blood Institute, U01-HL072507
Chinese Academy of Medical Sciences
Shanghai Cohort Study
National Institutes of Health, R01CA0403092
National Institutes of Health, R01CA144034
National Institutes of Health, R01-CA82729
National Institutes of Health, R37-CA70867
National Science Council and Department of Health, Taiwan
Department of Health, Taiwan, DOH80-27
Department of Health, Taiwan, DOH81-021
Department of Health, Taiwan, DOH8202-1027
Department of Health, Taiwan, DOH83-TD-015
Department of Health, Taiwan, DOH84-TD-006
National Institutes of Health, R01CA55069
National Institutes of Health, R35CA53890
National Institutes of Health, R01CA80205
National Institutes of Health, R01CA144034
Ministry of Education, Science and Technology, Korea, 2009-0087452
National Research Foundation of Korea, 2009-0087452
Japanese Ministry of Health, Labour and Welfare
U.S. Department of Energy
Department of Energy, DE-HS0000031
Ministry of Health, Labour and Welfare, Japan, Grantin-aid for Cancer Research
Ministry of Health, Labour and Welfare, Japan, Grant for the Third Term Comprehensive Control Research for Cancer
Ministry of Health, Labour and Welfare, Japan, Grant for Health Services
Ministry of Health, Labour and Welfare, Japan, Grant for Medical Services for Aged and Health Promotion
Ministry of Health, Labour and Welfare, Japan, Grant for Comprehensive Research on Cardiovascular and Life-style Related Diseases
Ministry of Education, Culture, Sports, Science and Technology, Japan, Grant for Scientific Research
National Cancer Center, Research and Development Fund
Publication Date
2014-04-22
Language
English
Notes
Due to the large number of authors, only the first 20 and the University of Chicago authors are included on the above author list. Please download the article for the complete list of authors.
Record Created
2024-02-06