Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium

Aysel Müezzinler; Ute Mons; Carolin Gellert; Ben Schöttker; Eugène Jansen; Frank Kee; Mark G O'Doherty; Kari Kuulasmaa; Neal D Freedman; Christian C Abnet; Alicja Wolk; Niclas Håkansson; Nicola Orsini; Tom Wilsgaard; Bas Bueno-de-Mesquita; Yvonne T van der Schouw; Petra H M Peeters; Lisette C P G M de Groot; Annette Peters; Philippos Orfanos; Allan Linneberg; Charlotta Pisinger; Abdonas Tamosiunas; Migle Baceviciene; Dalia Luksiene; Gailute Bernotiene; Pekka Jousilahti; Ulrika Petterson-Kymmer; Jan Håkan Jansson; Stefan Söderberg; Sture Eriksson; Nicole Jankovic; María-José Sánchez; Giovanni Veronesi; Susana Sans; Wojciech Drygas; Antonia Trichopoulou; Paolo Boffetta; Hermann Brenner

doi:10.1016/j.amepre.2015.04.004

Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium

Aysel Müezzinler, Ute Mons, Carolin Gellert, Ben Schöttker, Eugène Jansen, Frank Kee, Mark G O'Doherty, Kari Kuulasmaa, Neal D Freedman, Christian C Abnet, Alicja Wolk, Niclas Håkansson, Nicola Orsini, Tom Wilsgaard, Bas Bueno-de-Mesquita, Yvonne T van der Schouw, Petra H M Peeters, Lisette C P G M de Groot, Annette Peters, Philippos OrfanosAllan Linneberg, Charlotta Pisinger, Abdonas Tamosiunas, Migle Baceviciene, Dalia Luksiene, Gailute Bernotiene, Pekka Jousilahti, Ulrika Petterson-Kymmer, Jan Håkan Jansson, Stefan Söderberg, Sture Eriksson, Nicole Jankovic, María-José Sánchez, Giovanni Veronesi, Susana Sans, Wojciech Drygas, Antonia Trichopoulou, Paolo Boffetta, Hermann Brenner

38 Citations (Scopus)

Abstract

Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.

Original language	English
Journal	American Journal of Preventive Medicine
Volume	49
Issue number	5
Pages (from-to)	e53-e63
Number of pages	11
ISSN	0749-3797
DOIs	https://doi.org/10.1016/j.amepre.2015.04.004
Publication status	Published - Nov 2015

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.amepre.2015.04.004

Cite this

Müezzinler, A., Mons, U., Gellert, C., Schöttker, B., Jansen, E., Kee, F., O'Doherty, M. G., Kuulasmaa, K., Freedman, N. D., Abnet, C. C., Wolk, A., Håkansson, N., Orsini, N., Wilsgaard, T., Bueno-de-Mesquita, B., van der Schouw, Y. T., Peeters, P. H. M., de Groot, L. C. P. G. M., Peters, A., ... Brenner, H. (2015). Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium. American Journal of Preventive Medicine, 49(5), e53-e63. https://doi.org/10.1016/j.amepre.2015.04.004

Müezzinler, A, Mons, U, Gellert, C, Schöttker, B, Jansen, E, Kee, F, O'Doherty, MG, Kuulasmaa, K, Freedman, ND, Abnet, CC, Wolk, A, Håkansson, N, Orsini, N, Wilsgaard, T, Bueno-de-Mesquita, B, van der Schouw, YT, Peeters, PHM, de Groot, LCPGM, Peters, A, Orfanos, P, Linneberg, A, Pisinger, C, Tamosiunas, A, Baceviciene, M, Luksiene, D, Bernotiene, G, Jousilahti, P, Petterson-Kymmer, U, Jansson, JH, Söderberg, S, Eriksson, S, Jankovic, N, Sánchez, M-J, Veronesi, G, Sans, S, Drygas, W, Trichopoulou, A, Boffetta, P & Brenner, H 2015, 'Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium', American Journal of Preventive Medicine, vol. 49, no. 5, pp. e53-e63. https://doi.org/10.1016/j.amepre.2015.04.004

@article{2f1f0b7a9fce43e1aaa068cba8605e88,

title = "Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium",

abstract = "Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.",

author = "Aysel M{\"u}ezzinler and Ute Mons and Carolin Gellert and Ben Sch{\"o}ttker and Eug{\`e}ne Jansen and Frank Kee and O'Doherty, {Mark G} and Kari Kuulasmaa and Freedman, {Neal D} and Abnet, {Christian C} and Alicja Wolk and Niclas H{\aa}kansson and Nicola Orsini and Tom Wilsgaard and Bas Bueno-de-Mesquita and {van der Schouw}, {Yvonne T} and Peeters, {Petra H M} and {de Groot}, {Lisette C P G M} and Annette Peters and Philippos Orfanos and Allan Linneberg and Charlotta Pisinger and Abdonas Tamosiunas and Migle Baceviciene and Dalia Luksiene and Gailute Bernotiene and Pekka Jousilahti and Ulrika Petterson-Kymmer and Jansson, {Jan H{\aa}kan} and Stefan S{\"o}derberg and Sture Eriksson and Nicole Jankovic and Mar{\'i}a-Jos{\'e} S{\'a}nchez and Giovanni Veronesi and Susana Sans and Wojciech Drygas and Antonia Trichopoulou and Paolo Boffetta and Hermann Brenner",

year = "2015",

month = nov,

doi = "10.1016/j.amepre.2015.04.004",

language = "English",

volume = "49",

pages = "e53--e63",

journal = "American Journal of Preventive Medicine",

issn = "0749-3797",

publisher = "Elsevier",

number = "5",

}

TY - JOUR

T1 - Smoking and All-cause Mortality in Older Adults

T2 - Results From the CHANCES Consortium

AU - Müezzinler, Aysel

AU - Mons, Ute

AU - Gellert, Carolin

AU - Schöttker, Ben

AU - Jansen, Eugène

AU - Kee, Frank

AU - O'Doherty, Mark G

AU - Kuulasmaa, Kari

AU - Freedman, Neal D

AU - Abnet, Christian C

AU - Wolk, Alicja

AU - Håkansson, Niclas

AU - Orsini, Nicola

AU - Wilsgaard, Tom

AU - Bueno-de-Mesquita, Bas

AU - van der Schouw, Yvonne T

AU - Peeters, Petra H M

AU - de Groot, Lisette C P G M

AU - Peters, Annette

AU - Orfanos, Philippos

AU - Linneberg, Allan

AU - Pisinger, Charlotta

AU - Tamosiunas, Abdonas

AU - Baceviciene, Migle

AU - Luksiene, Dalia

AU - Bernotiene, Gailute

AU - Jousilahti, Pekka

AU - Petterson-Kymmer, Ulrika

AU - Jansson, Jan Håkan

AU - Söderberg, Stefan

AU - Eriksson, Sture

AU - Jankovic, Nicole

AU - Sánchez, María-José

AU - Veronesi, Giovanni

AU - Sans, Susana

AU - Drygas, Wojciech

AU - Trichopoulou, Antonia

AU - Boffetta, Paolo

AU - Brenner, Hermann

PY - 2015/11

Y1 - 2015/11

N2 - Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.

AB - Introduction Smoking is known to be a major cause of death among middle-aged adults, but evidence on its impact and the benefits of smoking cessation among older adults has remained limited. Therefore, we aimed to estimate the influence of smoking and smoking cessation on all-cause mortality in people aged ≥60 years. Methods Relative mortality and mortality rate advancement periods (RAPs) were estimated by Cox proportional hazards models for the population-based prospective cohort studies from Europe and the U.S. (CHANCES [Consortium on Health and Ageing: Network of Cohorts in Europe and the U.S.]), and subsequently pooled by individual participant meta-analysis. Statistical analyses were performed from June 2013 to March 2014. Results A total of 489,056 participants aged ≥60 years at baseline from 22 population-based cohort studies were included. Overall, 99,298 deaths were recorded. Current smokers had 2-fold and former smokers had 1.3-fold increased mortality compared with never smokers. These increases in mortality translated to RAPs of 6.4 (95% CI=4.8, 7.9) and 2.4 (95% CI=1.5, 3.4) years, respectively. A clear positive dose-response relationship was observed between number of currently smoked cigarettes and mortality. For former smokers, excess mortality and RAPs decreased with time since cessation, with RAPs of 3.9 (95% CI=3.0, 4.7), 2.7 (95% CI=1.8, 3.6), and 0.7 (95% CI=0.2, 1.1) for those who had quit <10, 10 to 19, and ≥20 years ago, respectively. Conclusions Smoking remains as a strong risk factor for premature mortality in older individuals and cessation remains beneficial even at advanced ages. Efforts to support smoking abstinence at all ages should be a public health priority.

U2 - 10.1016/j.amepre.2015.04.004

DO - 10.1016/j.amepre.2015.04.004

M3 - Journal article

C2 - 26188685

SN - 0749-3797

VL - 49

SP - e53-e63

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

IS - 5

ER -

Smoking and All-cause Mortality in Older Adults: Results From the CHANCES Consortium

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this