Smoking-attributable mortality in American Indians: findings from the Strong Heart Study

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• 作者：Mingzhi Zhang ; Qiang An ; Fawn Yeh ; Ying Zhang…
• 关键词：Cigarette smoking ; Mortality ; CVD ; Cancer ; All ; cause ; American Indians ; Strong Heart Study
• 刊名：European Journal of Epidemiology
• 出版年：2015
• 出版时间：July 2015
• 年：2015
• 卷：30
• 期：7
• 页码：553-561
• 全文大小：375 KB
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• 作者单位：Mingzhi Zhang (1) (2)
  Qiang An (1)
  Fawn Yeh (3)
  Ying Zhang (3) (4)
  Barbara V. Howard (4) (5)
  Elisa T. Lee (3) (4)
  Jinying Zhao (1)
  
  1. Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St. Suite 2000 SL-18, New Orleans, LA, 70112, USA
  2. Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, China
  3. Center for American Indian Health Research, University of Oklahoma Health Science Center, Oklahoma City, OK, 73012, USA
  4. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, 73104, USA
  5. MedStar Health Research Institute, Hyattsville, MD, 20782, USA
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Epidemiology
  Public Health
  Infectious Diseases
  Cardiology
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7284

文摘

Cigarette smoking is the leading preventable cause of death worldwide. American Indians have the highest proportion of smoking in the United States. However, few studies have examined the impact of cigarette smoking on disease mortality in this ethnically important but traditionally understudied minority population. Here we estimated the association of cigarette smoking with cardiovascular disease (CVD), cancer and all-cause mortality in American Indians participating in the Strong Heart Study, a large community-based prospective cohort study comprising of 4549 American Indians (aged 45-4?years) followed for about 20?years (1989-008). Hazard ratio and population attributable risk (PAR) associated with cigarette smoking were estimated by Cox proportional hazard model, adjusting for sex, study site, age, educational level, alcohol consumption, physical activity, BMI, lipids, renal function, hypertension or diabetes status at baseline, and interaction between current smoker and study site. We found that current smoking was significantly associated with cancer mortality (HR 5.0, [1.9-3.4]) in men, (HR 3.9 [1.6-.7] in women) and all-cause mortality (HR 1.8, [1.2-.6] in men, HR 1.6, [1.1-.4] in women). PAR for cancer and all-cause mortality in men were 41.0 and 18.4?%, respectively, whereas the corresponding numbers in women were 24.9 and 10.9?%, respectively. Current smoking also significantly increases the risk of CVD deaths in women (HR 2.2 [1.1, 4.4]), but not men (HR 1.2 [0.6-.4]). PAR for CVD mortality in women was 14.9?%. In summary, current smoking significantly increases the risk of CVD (in women), cancer and all-cause mortality in American Indians, independent of known risk factors. Culturally specific smoking cessation programs are urgently needed to reduce smoking-related premature deaths.