Mortality and Life Expectancy in Relation to Long-term Cigarette, Cigar and Pipe Smoking: the Zutphen Study

Overview

Journal Tob Control

Specialty Psychiatry

Date 2007 Apr 3

PMID 17400948

Citations 22

Authors

Martinette T Streppel

Hendriek C Boshuizen

Marga C Ocke

Frans J Kok

Daan Kromhout

Affiliations

Soon will be listed here.

Abstract

Study Objective: To study the effect of long-term smoking on all-cause and cause-specific mortality, and to estimate the effects of cigarette and cigar or pipe smoking on life expectancy.

Design: A long-term prospective cohort study.

Setting: Zutphen, The Netherlands.

Participants: 1373 men from the Zutphen Study, born between 1900 and 1920 and studied between 1960 and 2000.

Measurements: Hazard ratios for the type of smoking, amount and duration of cigarette smoking, obtained from a time-dependent Cox regression model. Absolute health effects of smoking are expressed as differences in life expectancy and the number of disease-free years of life.

Main Results: Duration of cigarette smoking was strongly associated with mortality from cardiovascular disease, lung cancer and chronic obstructive pulmonary disease, whereas both the number of cigarettes smoked as well as duration of cigarette smoking were strongly associated with all-cause mortality. Average cigarette smoking reduced the total life expectancy by 6.8 years, whereas heavy cigarette smoking reduced the total life expectancy by 8.8 years. The number of total life-years lost due to cigar or pipe smoking was 4.7 years. Moreover, cigarette smoking reduced the number of disease-free life-years by 5.8 years, and cigar or pipe smoking by 5.2 years. Stopping cigarette smoking at age 40 increased the life expectancy by 4.6 years, while the number of disease-free life-years was increased by 3.0 years.

Conclusions: Cigar or pipe smoking reduces life expectancy to a lesser extent than cigarette smoking. Both the number of cigarettes smoked and duration of smoking are strongly associated with mortality risk and the number of life-years lost. Stopping smoking after age 40 has major health benefits.

Citing Articles

Association of the age at smoking initiation and cessation on all-cause and cause-specific mortality: The Japan Collaborative Cohort Study.

Zuhal S, Kimura T, Tamakoshi A Nagoya J Med Sci. 2023; 85(4):691-712.

PMID: 38155620 PMC: 10751493. DOI: 10.18999/nagjms.85.4.691.

Association between Nontraditional Risk Factors and Calculated 10-Year Risk of Atherosclerotic Cardiovascular Disease in a Large General Population: Based on the Pars Cohort Study.

Ghorashi S, Ahmadi P, Shahnazar Nezhad Khalesi R, Fazeli A, Molavi Vardanjani H, Salehi A J Tehran Heart Cent. 2023; 18(1):24-32.

PMID: 37252217 PMC: 10225028. DOI: 10.18502/jthc.v18i1.12578.

Cotinine levels influence the risk of rupture of brain aneurysms.

Missori P, Aguiar de Sousa D, Ambrosone A, Curra A, Paolini S, Incarbone G Acta Neurol Scand. 2022; 146(5):562-567.

PMID: 35920037 PMC: 9805191. DOI: 10.1111/ane.13679.

Smoking intensity and urinary nicotine metabolites by socioeconomic status in the Heinz Nixdorf Recall study.

Hovanec J, Weiss T, Koch H, Pesch B, Behrens T, Kendzia B BMC Public Health. 2022; 22(1):302.

PMID: 35164711 PMC: 8842804. DOI: 10.1186/s12889-022-12609-y.

The presence of Superfund sites as a determinant of life expectancy in the United States.

Kiaghadi A, Rifai H, Dawson C Nat Commun. 2021; 12(1):1947.

PMID: 33850131 PMC: 8044172. DOI: 10.1038/s41467-021-22249-2.

References

DOLL R, Peto R . Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976; 2(6051):1525-36. PMC: 1690096. DOI: 10.1136/bmj.2.6051.1525. View

. Coronary heart disease in seven countries. I. The study program and objectives. Circulation. 1970; 41(4 Suppl):I1-8. View

Kuller L, Ockene J, Meilahn E, Wentworth D, Svendsen K, Neaton J . Cigarette smoking and mortality. MRFIT Research Group. Prev Med. 1991; 20(5):638-54. DOI: 10.1016/0091-7435(91)90060-h. View

Kawachi I, Colditz G, Stampfer M, Willett W, Manson J, Rosner B . Smoking cessation in relation to total mortality rates in women. A prospective cohort study. Ann Intern Med. 1993; 119(10):992-1000. DOI: 10.7326/0003-4819-119-10-199311150-00005. View

DOLL R, Peto R, Wheatley K, Gray R, Sutherland I . Mortality in relation to smoking: 40 years' observations on male British doctors. BMJ. 1994; 309(6959):901-11. PMC: 2541142. DOI: 10.1136/bmj.309.6959.901. View

Rigotti N, Pasternak R . Cigarette smoking and coronary heart disease: risks and management. Cardiol Clin. 1996; 14(1):51-68. DOI: 10.1016/s0733-8651(05)70260-5. View

Liaw K, Chen C . Mortality attributable to cigarette smoking in Taiwan: a 12-year follow-up study. Tob Control. 1998; 7(2):141-8. PMC: 1759691. DOI: 10.1136/tc.7.2.141. View

Jacobs Jr D, Adachi H, Mulder I, Kromhout D, Menotti A, Nissinen A . Cigarette smoking and mortality risk: twenty-five-year follow-up of the Seven Countries Study. Arch Intern Med. 1999; 159(7):733-40. DOI: 10.1001/archinte.159.7.733. View

Enstrom J . Smoking cessation and mortality trends among two United States populations. J Clin Epidemiol. 1999; 52(9):813-25. DOI: 10.1016/s0895-4356(99)00040-2. View

10.

Rachet B, Siemiatycki J, Abrahamowicz M, Leffondre K . A flexible modeling approach to estimating the component effects of smoking behavior on lung cancer. J Clin Epidemiol. 2004; 57(10):1076-85. DOI: 10.1016/j.jclinepi.2004.02.014. View

11.

DEN HARTOG C, VAN SCHAIKT , DALDERUP L, DRION E, Mulder T . THE DIET OF VOLUNTEERS PARTICIPATING IN A LONG TERM EPIDEMIOLOGICAL FIELD SURVEY ON CORONARY HEART DISEASE AT ZUTPHEN, THE NETHERLANDS. Voeding. 1965; 26:184-208. View

12.

Iso H, Date C, Yamamoto A, Toyoshima H, Watanabe Y, Kikuchi S . Smoking cessation and mortality from cardiovascular disease among Japanese men and women: the JACC Study. Am J Epidemiol. 2005; 161(2):170-9. DOI: 10.1093/aje/kwi027. View

13.

Zhang B, Ferrence R, Cohen J, Bondy S, Ashley M, Rehm J . Smoking cessation and lung cancer mortality in a cohort of middle-aged Canadian women. Ann Epidemiol. 2005; 15(4):302-9. DOI: 10.1016/j.annepidem.2004.08.013. View

14.

Al Mamun A, Peeters A, Barendregt J, Willekens F, Nusselder W, Bonneux L . Smoking decreases the duration of life lived with and without cardiovascular disease: a life course analysis of the Framingham Heart Study. Eur Heart J. 2004; 25(5):409-15. DOI: 10.1016/j.ehj.2003.12.015. View

15.

Jacobs E, Thun M, Apicella L . Cigar smoking and death from coronary heart disease in a prospective study of US men. Arch Intern Med. 2000; 159(20):2413-8. DOI: 10.1001/archinte.159.20.2413. View

16.

Nusselder W, Looman C, Marang-van de Mheen P, van de Mheen H, Mackenbach J . Smoking and the compression of morbidity. J Epidemiol Community Health. 2000; 54(8):566-74. PMC: 1731729. DOI: 10.1136/jech.54.8.566. View

17.

Qiao Q, Tervahauta M, Nissinen A, Tuomilehto J . Mortality from all causes and from coronary heart disease related to smoking and changes in smoking during a 35-year follow-up of middle-aged Finnish men. Eur Heart J. 2000; 21(19):1621-6. DOI: 10.1053/euhj.2000.2151. View

18.

Chao A, Thun M, Jacobs E, Henley S, Rodriguez C, Calle E . Cigarette smoking and colorectal cancer mortality in the cancer prevention study II. J Natl Cancer Inst. 2000; 92(23):1888-96. DOI: 10.1093/jnci/92.23.1888. View

19.

Wakai K, Seki N, Tamakoshi A, Kondo T, Nishino Y, Ito Y . Decrease in risk of lung cancer death in males after smoking cessation by age at quitting: findings from the JACC study. Jpn J Cancer Res. 2001; 92(8):821-8. PMC: 5926829. DOI: 10.1111/j.1349-7006.2001.tb01167.x. View

20.

Bronnum-Hansen H, Juel K . Abstention from smoking extends life and compresses morbidity: a population based study of health expectancy among smokers and never smokers in Denmark. Tob Control. 2001; 10(3):273-8. PMC: 1747595. DOI: 10.1136/tc.10.3.273. View