Modeling mortality risk effects of cigarettes and smokeless tobacco: results from the National Health Interview Survey Linked Mortality File Data

BMC Public Health

Esther Salazar¹  Brian L. Rostron¹  Chunfeng Ren¹  Ghideon Solomon¹ 

[1] Center for Tobacco Products, U.S. Food and Drug Administration, 11785 Beltsville Dr., 20705, Calverton, MD, USA;

关键词: Mortality risk;    Cigarettes;    Smokeless tobacco;   

DOI  :  10.1186/s12889-021-11801-w

来源: Springer

【 摘 要 】

BackgroundCigarettes and smokeless tobacco (SLT) products are among a wide range of tobacco products that are addictive and pose a significant health risk. In this study, we estimated smoking- and SLT use-related mortality hazard ratios (HRs) among U.S. adults by sex, age group, and cause of death, for nine mutually exclusive categories of smoking and/or SLT use.MethodsWe used data from the public-use National Health Interview Survey Linked Mortality with mortality follow-up through 2015. We used Cox proportional hazard models to estimate mortality HRs, adjusted by race/ethnicity, education, poverty level, body mass index, and tobacco-use status.ResultsWith never users as reference group, HRs for smoking-related diseases for male exclusive current smokers aged 35–64 and 65+ were 2.18 (95% confidence interval [CI]: 1.79–2.65), and 2.45 (95% CI: 2.14–2.79), respectively. Similar significant HR estimates were found for females and for all-cause mortality (ACM) and other-cause mortality (OCM) outcomes. HRs for exclusive current SLT users were only significant for males aged 35–64 for ACM (HR: 2.04, 95% CI: 1.27–3.27) and OCM (HR: 2.80, 95% CI: 1.50–5.25). HRs for users who switched from cigarettes to SLT products were significant for males aged 65+ for smoking-related diseases (HR: 2.06, 95% CI: 1.47–2.88), SLT-related diseases (HR: 1.99, 95% CI: 1.36–2.89), and ACM (HR: 1.63, 95% CI: 1.21–2.19).ConclusionsMale exclusive current SLT users aged 35–64 had a significant HR for ACM and OCM outcomes, suggesting that deaths not attributed to SLT use could be contributing to the ACM elevated HR for exclusive current SLT users.

【 授权许可】

CC BY