Smoking behavioral changes and subsequent mortality during a 18-year follow-up in Kinmen, Taiwan

Abstract

Background: The aim of this study was to examine the changes in smoking behavior over 6 years and to relate these changes to mortality risk during 18 years' follow-up.

Methods: We followed a cohort for 6 years (1991-1997) to assess changes in smoking behavior and then for an additional 12 years (1997-2008) to relate these findings to mortality in 4986 Chinese individuals. Participants were classified as never smokers, long-term quitters, new smokers, new quitters, and continuing smokers. Mortality was ascertained by linkage with the nationwide death registry.

Results: Compared with never smokers, continuing smokers had the highest risk of 1.84 [95% confidence interval (CI): 1.38, 2.45] for all-cause mortality, new quitters had a risk of 1.49 (95% CI: 1.04, 2.15), new smokers had a risk of 1.26 (95% CI: 0.59, 2.68), and long-term quitters had a risk of 1.11 (95% CI: 0.64, 1.91). There was a significant 19% risk reduction in all-cause mortality for new quitters.

Conclusion: Smoking cessation was associated with a significant reduction in mortality risk within approximately 6 years, while no significantly increased risk was observed for long-term quitters.

Keywords: Chinese; mortality; repeated assessment; smoking; smoking behavior.