Mortality Among Male Cigar and Cigarette Smokers in the U.S.

Malignant Neoplasms ◽

Hazard Ratios ◽

Low Prevalence ◽

Abstract Background. Cigars and cigarettes are both smoked, but much less is known about the former’s long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose. We conducted a follow-up mortality study of cigar-smoking men age 40-79 years in National Health Interview Surveys (NHIS). We utilized Methods. We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December 31, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income, health status, body mass index, and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases.Results. There were 14,628 deaths from all causes, including 3,420 never tobacco users, 3,266 exclusive smokers, and 176 exclusive cigar users. The latter had significantly increased mortality only from chronic lower respiratory diseases (HR = 2.60, CI = 1.04 – 6.50), which was based on 6 deaths. We found no statistically significant evidence among exclusive cigar smokers of increased mortality from any other cause.Conclusions. This study provides evidence that male cigar smokers had elevated mortality risks. However, after accounting for cigarette smoking, we found significantly increased mortality only for chronic lower respiratory diseases.

Mortality Among Male Cigar and Cigarette Smokers in the U.S.

10.21203/rs.3.rs-55896/v3 ◽

2020 ◽

Author(s):

Brad Rodu ◽

Nantaporn Plurphanswat

Keyword(s):

Cerebrovascular Disease ◽

Proportional Hazards ◽

Heart Diseases ◽

Malignant Neoplasms ◽

Cigarette Smokers ◽

Low Prevalence ◽

Abstract Background. Cigars and cigarettes are both smoked, but much less is known about the former’s long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose. We conducted a follow-up mortality study of cigar-smoking men age 40-79 years in National Health Interview Surveys (NHIS). Methods. We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December 31, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases. Results. There were 14,657 deaths from all causes, including 3,426 never tobacco users, 3,276 exclusive cigarette smokers, and 176 exclusive cigar users. The latter had no statistically significant evidence of increased mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, smoking related diseases or other causes. In contrast, the mortality experience of dual users of cigars and cigarettes and cigar smokers who formerly used cigarettes is similar to exclusive cigarette smokers. Conclusions. This study provides evidence that male cigar smokers age 40+ years had elevated mortality risks. However, after accounting for cigarette smoking and other confounding variables, we found significantly increased mortality only among dual and former users of cigarettes.

Mortality Among Male Cigar and Cigarette Smokers in the U.S.

10.21203/rs.3.rs-55896/v2 ◽

2020 ◽

Author(s):

Brad Rodu ◽

Nantaporn Plurphanswat

Keyword(s):

Cerebrovascular Disease ◽

Proportional Hazards ◽

Heart Diseases ◽

Malignant Neoplasms ◽

Cigarette Smokers ◽

Low Prevalence ◽

Abstract Background. Cigars and cigarettes are both smoked, but much less is known about the former’s long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose. We conducted a follow-up mortality study of cigar-smoking men age 40-79 years in National Health Interview Surveys (NHIS). Methods. We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December 31, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income, health status, body mass index, and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases. Results. There were 14,628 deaths from all causes, including 3,420 never tobacco users, 3,266 exclusive cigarette smokers, and 176 exclusive cigar users. The latter had no statistically significant evidence of increased mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, smoking related diseases or other causes. In contrast, the mortality experience of dual users of cigars and cigarettes and cigar smokers who formerly used cigarettes is similar to exclusive cigarette smokers. Conclusions. This study provides evidence that male cigar smokers age 40+ years had elevated mortality risks. However, after accounting for cigarette smoking and other confounding variables, we found significantly increased mortality only among dual and former users of cigarettes.

Mortality among male cigar and cigarette smokers in the USA

Harm Reduction Journal ◽

10.1186/s12954-020-00446-4 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Brad Rodu ◽

Nantaporn Plurphanswat

Keyword(s):

Cerebrovascular Disease ◽

Proportional Hazards ◽

Heart Diseases ◽

Malignant Neoplasms ◽

Cigarette Smokers ◽

The Usa ◽

Abstract Background Cigars and cigarettes are both smoked, but much less is known about the former’s long-term health effects, due to its low prevalence and infrequent collection of cigar information in national surveys. Purpose We conducted a follow-up mortality study of cigar-smoking men age 40–79 years in National Health Interview Surveys (NHIS). Methods We used pooled NHIS files linked to the National Death Index to obtain follow-up from year of interview to year of death or December 31, 2015. We developed categories of cigarette and cigar smoking that accommodate dual and former use of both products. We used Cox proportional hazards models, adjusted for age, race/ethnicity, marital status, education, income and region to estimate hazard ratios (HRs, 95% confidence intervals, CI) for mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, chronic lower respiratory diseases and two mutually exclusive categories: smoking-related and other diseases. Results There were 14,657 deaths from all causes, including 3426 never tobacco users, 3276 exclusive cigarette smokers and 176 exclusive cigar users. The latter had no statistically significant evidence of increased mortality from all causes, heart diseases, malignant neoplasms, cerebrovascular disease, smoking-related diseases or other causes. In contrast, the mortality experience of dual users of cigars and cigarettes and cigar smokers who formerly used cigarettes is similar to exclusive cigarette smokers. Conclusions This study provides evidence that male cigar smokers age 40 + years had elevated mortality risks. However, after accounting for cigarette smoking and other confounding variables, we found significantly increased mortality only among dual and former users of cigarettes.

Visual impairment and risk of dementia in two population-based prospective cohorts: UK Biobank and EPIC-Norfolk

The Journals of Gerontology Series A ◽

10.1093/gerona/glab325 ◽

2021 ◽

Author(s):

Thomas J Littlejohns ◽

Shabina Hayat ◽

Robert Luben ◽

Carol Brayne ◽

Megan Conroy ◽

...

Keyword(s):

Visual Impairment ◽

Proportional Hazards ◽

Population Based ◽

Uk Biobank ◽

Hazard Ratios ◽

Promising Target ◽

Increased Risk

Abstract Visual impairment has emerged as a potential modifiable risk factor for dementia. However, there are a lack of large studies with objective measures of vison and with more than ten years of follow-up. We investigated whether visual impairment is associated with an increased risk of incident dementia in UK Biobank and EPIC-Norfolk. In both cohorts, visual acuity was measured using a “logarithm of the minimum angle of resolution” (LogMAR) chart and categorised as no (≤0.30 LogMAR), mild (>0.3 - ≤0.50 LogMAR), and moderate to severe (>0.50 LogMAR) impairment. Dementia was ascertained through linkage to electronic medical records. After restricting to those aged ≥60 years, without prevalent dementia and with eye measures available, the analytic samples consisted of 62,206 UK Biobank and 7,337 EPIC-Norfolk participants, respectively. In UK Biobank and EPIC-Norfolk. respectively, 1,113 and 517 participants developed dementia over 11 and 15 years of follow-up. Using multivariable cox proportional-hazards models, the hazard ratios for mild and moderate to severe visual impairment were 1.26 (95% Confidence Interval [CI] 0.92-1.72) and 2.16 (95% CI 1.37-3.40), in UK Biobank, and 1.05 (95% CI 0.72-1.53) and 1.93 (95% CI 1.05-3.56) in EPIC-Norfolk, compared to no visual impairment. When excluding participants censored within 5 years of follow-up or with prevalent poor or fair self-reported health, the direction of the associations remained similar for moderate impairment but were not statistically significant. Our findings suggest visual impairment might be a promising target for dementia prevention, however the possibility of reverse causation cannot be excluded.

Sex differences in the 10-year survival of patients undergoing maintenance hemodialysis in the Q-Cohort Study

Scientific Reports ◽

10.1038/s41598-021-03551-x ◽

2022 ◽

Vol 12 (1) ◽

Author(s):

Hiroaki Tsujikawa ◽

Shunsuke Yamada ◽

Hiroto Hiyamuta ◽

Masatomo Taniguchi ◽

Kazuhiko Tsuruya ◽

...

Keyword(s):

Proportional Hazards ◽

Japanese Patients ◽

Hemodialysis Patients ◽

Maintenance Hemodialysis ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Related Mortality

AbstractWomen have a longer life expectancy than men in the general population. However, it has remained unclear whether this advantage is maintained in patients undergoing maintenance hemodialysis. The aim of this study was to compare the risk of mortality, especially infection-related mortality, between male and female hemodialysis patients. A total of 3065 Japanese hemodialysis patients aged ≥ 18 years old were followed up for 10 years. The primary outcomes were all-cause and infection-related mortality. The associations between sex and these outcomes were examined using Cox proportional hazards models. During the median follow-up of 8.8 years, 1498 patients died of any cause, 387 of whom died of infection. Compared with men, the multivariable-adjusted hazard ratios (95% confidence interval) for all-cause and infection-related mortality in women were 0.51 (0.45–0.58, P < 0.05) and 0.36 (0.27–0.47, P < 0.05), respectively. These findings remained significant even when propensity score-matching or inverse probability of treatment weighting adjustment methods were employed. Furthermore, even when the non-infection-related mortality was considered a competing risk, the infection-related mortality rate in women was still significantly lower than that in men. Regarding all-cause and infection-related deaths, women have a survival advantage compared with men among Japanese patients undergoing maintenance hemodialysis.

Colours of fruit and vegetables and 10-year incidence of CHD

British Journal Of Nutrition ◽

10.1017/s0007114511001942 ◽

2011 ◽

Vol 106 (10) ◽

pp. 1562-1569 ◽

Cited By ~ 33

Author(s):

Linda M. Oude Griep ◽

W. M. Monique Verschuren ◽

Daan Kromhout ◽

Marga C. Ocké ◽

Johanna M. Geleijnse

Keyword(s):

Proportional Hazards ◽

Population Based ◽

Fruit And Vegetables ◽

Orange Yellow ◽

Hazard Ratios ◽

Orange Fruit ◽

Incident Cases

The colours of the edible part of fruit and vegetables indicate the presence of specific micronutrients and phytochemicals. The extent to which fruit and vegetable colour groups contribute to CHD protection is unknown. We therefore examined the associations between fruit and vegetables of different colours and their subgroups and 10-year CHD incidence. We used data from a prospective population-based cohort including 20 069 men and women aged 20–65 years who were enrolled between 1993 and 1997. Participants were free of CVD at baseline and completed a validated 178-item FFQ. Hazard ratios (HR) for the association between green, orange/yellow, red/purple, white fruit and vegetables and their subgroups with CHD were calculated using multivariable Cox proportional hazards models. During 10 years of follow-up, 245 incident cases of CHD were documented. For each 25 g/d increase in the intake of the sum of all four colours of fruit and vegetables, a borderline significant association with incident CHD was found (HR 0·98; 95 % CI 0·97, 1·01). No clear associations were found for the colour groups separately. However, each 25 g/d increase in the intake of deep orange fruit and vegetables was inversely associated with CHD (HR 0·74; 95 % CI 0·55, 1·00). Carrots, their largest contributor (60 %), were associated with a 32 % lower risk of CHD (HR 0·68; 95 % CI 0·48, 0·98). In conclusion, though no clear associations were found for the four colour groups with CHD, a higher intake of deep orange fruit and vegetables and especially carrots may protect against CHD.

Use of disease-modifying antirheumatic drugs and the subsequent risk of herpes zoster in older adults

Rheumatology ◽

10.1093/rheumatology/keab538 ◽

2021 ◽

Author(s):

Jiahui Qian ◽

Marissa Nichole Lassere ◽

Anita Elizabeth Heywood ◽

Bette Liu

Keyword(s):

Herpes Zoster ◽

Proportional Hazards ◽

Population Based ◽

Antiviral Therapies ◽

Hazard Ratios ◽

Using Data ◽

Subsequent Risk

Abstract Objectives To examine the association between DMARD use and subsequent risk of herpes zoster in a large, heterogeneous, and prospective population-based cohort. Methods Using data from a cohort of adults (45 and Up Study) recruited between 2006 and 2009 and linked to pharmaceutical, hospital and death data (2004–2015), the effect of DMARD use on zoster risk was analysed using Cox proportional hazards models, adjusting for sociodemographic characteristics, comorbidities and corticosteroid use. Results Among 254 065 eligible participants, over 1,826 311 person-years follow-up, there were 6295 new DMARD users and 17 024 incident herpes zoster events. Compared with non-users, the risk of zoster was higher in those who used bDMARDs, either alone or in combination with csDMARDs than in those who only used csDMARDs (adjusted hazard ratios, aHR 2.53 [95% confidence interval, CI 2.03–3.16]) for bDMARDs vs 1.48 [95%CI 1.33–1.66] for csDMARDs, p-heterogeneity < 0.001; reference: non-users). Among users of csDMARDs, compared with non-users, zoster risks were highest in those using exclusively cyclophosphamide (aHR 2.69 [95%CI 1.89–3.83]), more moderate in those using azathioprine (aHR 1.57 [95%CI 1.07–2.30]) and hydroxychloroquine (aHR 1.43 [95%CI 1.11–1.83]) and not elevated in users of methotrexate (aHR 1.24 [95%CI 0.98–1.57]), sulfasalazine (aHR 1.00 [95%CI 0.71–1.42]) and leflunomide (aHR 0.41 [95%CI 0.06–2.88]). Conclusions The risk of zoster was high among bDMARD and cyclophosphamide users. Also, the risk was increased in those using hydroxychloroquine alone and in combination with methotrexate but not methotrexate alone. Preventative strategies such as zoster vaccination or antiviral therapies should be considered in these populations if not contraindicated.

Combined effect of fasting glucose and body mass index on mortality by age and sex in over 15 million adults: a cohort study

European Heart Journal ◽

10.1093/ehjci/ehaa946.2814 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

M Jung ◽

S.W Yi ◽

S.J An ◽

S.H Ihm

Keyword(s):

Body Mass Index ◽

Body Mass ◽

Proportional Hazards ◽

Fasting Glucose ◽

Fasting Blood Glucose ◽

Younger Adults ◽

Hazard Ratios

Abstract Background We aimed to elucidate whether synergic combined association of body mass index (BMI) and fasting blood glucose (FBG) on mortality exist and to identify FBS-BMI subgroups with higher mortality according to sex and age. Methods A total of 15,149,275 Korean adults participated in health examinations during 2003–2006 and were followed up until December 2018. Hazard ratios (HRs) of 40 BMI-FBG combined groups for mortality were assessed by Cox proportional hazards models. Results During mean 13.7 years of follow-up, 1,213,401 individuals died. The association between hyperglycemia and mortality was stronger in leaner than more obese individuals and these effects were more prominent in younger than older adults. Compared with overweight (BMI 25–27.4kg/m2) normoglycemic (FBG 80–94mg/dL), age, sex-adjusted HRs of leanest (BMI <20kg/m2) normoglycemic, overweight diabetes (FBG ≥180mg/dL), and leanest diabetes were 1.66, 2.17, and 4.77, respectively. Corresponding HRs in those aged 18–44 years were 1.29, 2.59, and 11.18, respectively, while corresponding HRs in those aged 75–99 years were 1.56, 1.72, and 2.87, respectively (Figure 1). The interpretation of BMI-FBG subgroups associated with higher mortality was not straightforward. For example, prediabetes (FBG 110–125 mg/dL) with BMI 20–22.4 kg/m2 had similar or higher mortality than low diabetes (FBG 126–179 mg/dL) with BMI ≥22.5 kg/m2. In non-diabetic women aged <45 years, BMI ≥27.5 kg/m2 was associated with the highest mortality, whereas the leanest had the worst mortality in each given FBG level in other age-sex groups. Conclusions Leanness and hyperglycemia interact together to increase mortality supra-multiplicatively, especially in younger adults, while complex interaction of BMI, FBG, sex and age on mortality exist. Figure 1 Funding Acknowledgement Type of funding source: None

Probable REM sleep behavior disorder and risk of stroke

Neurology ◽

10.1212/wnl.0000000000003902 ◽

2017 ◽

Vol 88 (19) ◽

pp. 1849-1855 ◽

Cited By ~ 24

Author(s):

Chaoran Ma ◽

Milena Pavlova ◽

Yesong Liu ◽

Ying Liu ◽

Chunmei Huangfu ◽

...

Keyword(s):

Rem Sleep ◽

Proportional Hazards ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Sleep Behavior ◽

Hazard Ratios ◽

Increased Risk

Objective:To examine whether probable REM sleep behavior disorder (pRBD) was associated with increased risk of developing stroke in a community-based cohort.Methods:The study included 12,003 participants (mean age 54.0 years) of the Kailuan Study, free of stroke, cancer, Parkinson disease, dementia, and head injury at baseline (2012). We determined pRBD using a validated REM sleep behavior disorder (RBD) questionnaire in 2012. Incident stroke cases were confirmed by review of medical records. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of stroke according to pRBD status, adjusting for several sleep measures (i.e., insomnia, daytime sleepiness, sleep duration, snoring, and use of hypnotics) and other potential confounders.Results:During 3 years of follow-up, we documented 159 incident stroke cases. Relative to participants without pRBD at the baseline, those with pRBD had a 157% higher risk (95% CI 59%–313%) of developing stroke. Presence of pRBD was associated with increased risk of both stroke types—the adjusted HR was 1.93 (95% CI 1.07–3.46) for ischemic stroke and 6.61 (95% CI 2.27–19.27) for hemorrhagic stroke.Conclusions:Presence of pRBD was associated with a higher risk of developing stroke, including both ischemic and hemorrhagic types. Future studies with clinically confirmed RBD and a longer follow-up would be appropriate to further investigate this association.

Prediagnosis Body Mass Index and Risk of Secondary Primary Cancer in Male Cancer Survivors: A Large Cohort Study

Journal of Clinical Oncology ◽

10.1200/jco.2016.66.4920 ◽

2016 ◽

Vol 34 (34) ◽

pp. 4116-4124 ◽

Cited By ~ 18

Author(s):

Sang Min Park ◽

Young Ho Yun ◽

Young Ae Kim ◽

Minkyung Jo ◽

Young-Joo Won ◽

...

Keyword(s):

Body Mass Index ◽

General Population ◽

Cancer Survivors ◽

Body Mass ◽

Proportional Hazards ◽

Hazard Ratios ◽

Risk Of Cancer

Purpose Male cancer survivors have a higher risk of cancer than the general population, which might be caused by an increased prevalence of obesity or susceptibility to obesity-related carcinogenesis. We assessed the effects of obesity before the diagnosis of a first cancer on the development of secondary primary cancers (SPCs). Methods The study population consisted of 239,615 Korean male cancer survivors between January 2003 and December 2010. Incident SPCs were assessed throughout follow-up until December 2011. Cox proportional hazards models were used to calculate the hazard ratios of SPCs associated with prediagnosis body mass index (BMI), which were compared with those of first cancers in all cohort participants. Results After 1,614,583 person-years of follow-up, we observed 4,799 patients with SPC. The age-standardized incidence rate of cancer in cancer survivors was 1.1 times higher than that of the general population. We found positive linear trends between prediagnosis BMI and risk of all-combined, colorectal, liver, lymphoma, biliary tract, kidney, and obesity-related SPCs. The magnitude of the BMI-SPC risk association in male cancer survivors was stronger than that for first cancers in the general population, whereas the mean BMI was similar in both groups. In the severely obese category (BMI ≥ 30 kg/m2), the adjusted hazard ratios for SPCs among cancer survivors (1.41; 95% CI, 1.15 to 1.74) were significantly higher than those for first cancers among all cohort participants (1.12; 95% CI, 1.09 to 1.16; Pheterogeneity < .01). Conclusion Prediagnosis obesity is a risk factor for overall and individual SPCs, and the strength of the BMI-cancer association is slightly stronger in male cancer survivors than in the general population.