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. 2017 Jul 19;18(1):34.
doi: 10.1186/s12889-017-4590-3.

Smoking-related general and cause-specific mortality in Estonia

Gea Kõks  1 , Krista Fischer  2 , Sulev Kõks  3   4
Affiliations

Smoking-related general and cause-specific mortality in Estonia

Gea Kõks et al. BMC Public Health. .

Erratum in

  • Erratum to: BMC Public Health, Vol. 18.
    [No authors listed] [No authors listed] BMC Public Health. 2017 Sep 22;17(1):736. doi: 10.1186/s12889-017-4709-6. BMC Public Health. 2017. PMID: 28938882 Free PMC article. No abstract available.

Abstract

Background: Tobacco smoking is known to be the single largest cause of premature death worldwide. The aim of present study was to analyse the effect of smoking on general and cause-specific mortality in the Estonian population.

Methods: The data from 51,756 adults in the Estonian Genome Center of the University of Tartu was used. Information on dates and causes of death was retrieved from the National Causes of Death Registry. Smoking status, general survival, general mortality and cause-specific mortality were analysed using Kaplan-Meier estimator and Cox proportional hazards models.

Results: The study found that smoking reduces median survival in men by 11.4 years and in women by 5.8 years. Tobacco smoking produces a very specific pattern in the cause of deaths, significantly increasing the risks for different cancers and cardiovascular diseases as causes of death for men and women. This study also identified that external causes, such as alcohol intoxication and intentional self-harm, are more prevalent causes of death among smokers than non-smokers. Additionally, smoking cessation was found to reverse the increased risks for premature mortality.

Conclusions: Tobacco smoking remains the major cause for losses of life inducing cancers and cardiovascular diseases. In addition to the common diseases, external causes also reduce substantially the years of life. External causes of death indicate that smoking has a long-term influence on the behaviour of smokers, provoking self-destructive behaviour. Our study supports the idea, that tobacco smoking generates complex harm to our health increasing mortality from both somatic and mental disorders.

Keywords: Cancer; Cause of death; Mortality; Smoking; Survival.

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Conflict of interest statement

Ethics approval and consent to participate

The Ethics Review Committee on Human Research of the University of Tartu approved the protocols and informed-consent forms used in this study. All of the participants signed a written informedconsent form.

Consent for publication

Not applicable.

Competing interests

Authors declare that they do not have any competing interests regarding to the present manuscript and funding.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival probabilities for current and former smokers and for men and women who have never smoked. Reduced survival of the smokers is evident
Fig. 2
Fig. 2
Forest plot of the hazard ratio (HR) for specific causes of death illustrates the profile of the major causes of death in currently smoking men. Age-adjusted Cox regression modelling was applied
Fig. 3
Fig. 3
Forest plot of the hazard ratio (HR) for specific causes of death illustrates the profile of the major causes of death in currently smoking women. Age-adjusted Cox regression modelling was applied
See this image and copyright information in PMC

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