Smoking & Mortality

It is well established in the literature that cigarette smoking is harmful to a person’s health, causing COPD, cancer, and cardiovascular diseases. A 25-year follow-up of a study, originally fielded in the late 1950s and early 1960s, examined the increased mortality rates associated with smokers. However, in 1980, a multivariate analysis of death and coronary heart disease known as the Seven Countries Study was published which indicated that cigarette smoking was less predictive of coronary heart disease in southern Europe and Japan than in the US and northern Europe. This 1980 analysis was a 10-year follow-up of a study fielded between 1957 and 1965 that followed 12 763 men age 40 to 59 years old in 16 cohorts throughout 7 countries (1 in the US, 2 in Finland, 1 in the Netherlands, 3 in Italy, 2 in Croatia, 3 in Serbia, 2 in Greece, and 2 in Japan).

In 1999, Archives of Internal Medicine published a 25-year follow-up on the same 12 763 men. The hypothesis of this analysis was that smoking would be consistently, and universally, associated with several causes of death. After 25 years, the vital status of all but 56 men was known.

The results showed that the rates of death from coronary heart disease, COPD, lung cancer, and other cancer (oral cavity, esophagus, larynx, bladder, pancreas, and kidney) were much higher among people who smoked than people who never smoked. In addition, the rates of death (particularly for lung cancer and COPD) were clearly related to the number of cigarettes smoked per day. People who smoked more than 30 cigarettes each day had a 21% elevation in the 25-year total death rate than people who never smoked.

The 25-year follow-up demonstrated that cigarette smoking is universally and consistently related to select causes of death. It can also be inferred that people who are smokers are more likely than nonsmokers to suffer from several comorbid conditions, including cardiovascular disease, several types of cancer, and COPD.

In Summary;

• smoking is the single most important cause of COPD, accounting for 80% to 90% of all risk for developing the disease
• chronic bronchitis symptoms are at least 4 times more likely in smokers than nonsmokers
• a patient’s risk is measured in “pack years” of smoked cigarettes, with 20 pack years or more identified as a predictor of COPD as age increases, loss of pulmonary function accelerates quickly with continued smoking