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

Abstract

Aims: The risk of early and late death in relation to smoking and ex-smoking were studied.

Methods and results: A cohort of 1711 Finnish men born between 1900 and 1919 were recruited in 1959 and followed up for 35 years. Information on smoking status was collected at each of six examinations made from 1959 to 1989 using a standardized questionnaire. Vital status at the end of 1994 was collected for every man. The effect of smoking on mortality was assessed using Cox proportional hazards model. Adjusted ratios for 35-year all-cause mortality were 1.62 (95% CI 1.40-1.88) in current smokers and 1.13 (CI 0.93-1.36) in former smokers compared with non-smokers. The hazards ratios for 35-year coronary heart disease mortality were 1. 63 (CI 1.24-2.13) and 1.39 (CI 1.00-1.94), respectively. The risk for 10 year mortality was stronger than for 35 year mortality among both former and current smokers, given the same amount of cigarettes consumed. Men smoking persistently were most at risk, while those who persisted in quitting had no increased risk of death compared with non-smokers.

Conclusion: Smoking increases the risk of premature death in middle-aged men and giving up smoking earlier in life can prevent smoking attributable premature death.