Young Sik Park1, Sangshin Park2,3, Chang-Hoon Lee1. 1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea. 2. Department of Pediatrics, Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, United States. 3. Graduate School of Urban Public Health, University of Seoul, Seoul, South Korea.
Abstract
Background: It was not evident that the attributable risk of smoking on mortality in Korea was reduced. We investigated the impacts of smoking on all-cause mortality and estimated attributable risk of smoking in Korean adults. Methods: Those aged ≥ 20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized participants into three groups as follows: never smoker, < 20 pack-years (PY) smokers and ≥ 20PY smokers. We applied inverse probability weighting by using propensity score to control various confounders between groups. All-cause mortality risks were compared between groups by using Kaplan-Meier log-rank test. Smoking attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. ≥ 20PY smokers, < 20PY smokers and never smokers were 18.1%, 20.2% and 61.7% respectively. Smokers had higher risk of all-cause mortality compared to never smokers. (Log-rank test <0.01) ARs of smoking were 21.8% (95% CI, 5.7-37.9%) and 9.0% (95% CI, 6.1-12.0%) in male and female, respectively. ARs decreased from 24.2% to 19.5% in male and from 9.5% to 4.1% in female between 2007-2010 and 2011-2015. Conclusions: Our study using KNHANES IV-VI demonstrated smoking increased the risk of all-cause mortality in a dose-response relationship and ARs of smoking on mortality were 21.8% in male and 9.0% in female during 2007-2015. It could be suggested that ARs of smoking on mortality have been decreased since around 2010.
Background: It was not evident that the attributable risk of smoking on mortality in Korea was reduced. We investigated the impacts of smoking on all-cause mortality and estimated attributable risk of smoking in Korean adults. Methods: Those aged ≥ 20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized participants into three groups as follows: never smoker, < 20 pack-years (PY) smokers and ≥ 20PY smokers. We applied inverse probability weighting by using propensity score to control various confounders between groups. All-cause mortality risks were compared between groups by using Kaplan-Meier log-rank test. Smoking attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. ≥ 20PY smokers, < 20PY smokers and never smokers were 18.1%, 20.2% and 61.7% respectively. Smokers had higher risk of all-cause mortality compared to never smokers. (Log-rank test <0.01) ARs of smoking were 21.8% (95% CI, 5.7-37.9%) and 9.0% (95% CI, 6.1-12.0%) in male and female, respectively. ARs decreased from 24.2% to 19.5% in male and from 9.5% to 4.1% in female between 2007-2010 and 2011-2015. Conclusions: Our study using KNHANES IV-VI demonstrated smoking increased the risk of all-cause mortality in a dose-response relationship and ARs of smoking on mortality were 21.8% in male and 9.0% in female during 2007-2015. It could be suggested that ARs of smoking on mortality have been decreased since around 2010.