北京60岁及以上老年人吸烟状况与死亡风险的关联研究  

Association between smoking status and mortality risk among elderly people aged 60 and above in Beijing City

作　　者：陈仕敏 王盛书 刘少华 李雪航 李志强[1] 李皓炜 李蓉蓉[1] 王建华[1] 杨姗姗[3] 刘淼[4] 何耀[1,5] Chen Shimin;Wang Shengshu;Liu Shaohua;Li Xuehang;Li Zhiqiang;Li Haowei;Li Rongrong;Wang Jianhua;Yang Shanshan;Liu Miao;He Yao(Institute of Geriatrics,Beijing Key Laboratory of Aging and Geriatrics/National Clinical Research Center for Geriatric Diseases/Second Medical Center,Chinese People′s Liberation Army General Hospital,Beijing 100853,China;Department of Healthcare,Agency for Offices Administration,Central Military Commission,People′s Republic of China,Beijing 100082,China;Department of Disease Prevention and Control,First Medical Center,Chinese People′s Liberation Army General Hospital,Beijing 100853,China;Department of Statistics and Epidemiology,Graduate School,Chinese People′s Liberation Army General Hospital,Beijing 100853,China;State Key Laboratory of Kidney Diseases,Beijing 100853,China)

机构地区：[1]解放军总医院第二医学中心老年医学研究所衰老及相关疾病研究北京市重点实验室国家老年疾病临床医学研究中心,北京100853 [2]中央军委机关事务管理总局服务局保健室,北京100082 [3]解放军总医院第一医学中心疾病预防控制科,北京100853 [4]解放军总医院研究生院统计学与流行病学教研室,北京100853 [5]肾脏疾病国家重点实验室,北京100853

出　　处：《中华预防医学杂志》2023年第9期1403-1411,共9页Chinese Journal of Preventive Medicine

基　　金：国家自然科学基金(82173589,82173590);首都卫生发展科研专项(2022-2G-5031);国家重点研发计划(2022YFC2503605)。

摘　　要：目的分析北京城乡老年人群吸烟状况与相关死亡风险间的关联。方法基于北京城乡老年人群健康综合研究2009—2014年的队列数据,纳入符合标准的60岁及以上老年人群4499名,随访其生存与死亡结局。采用Cox比例风险模型分析吸烟状态、吸烟指数、戒烟年数与死亡风险间的关联。结果4499名研究对象年龄M(IQR)为70.00(10.00)岁,其中男性1814名(40.32%);从不吸烟者、戒烟者和现在吸烟者分别有69.50%(3127/4499)、13.20%(594/4499)和17.30%(778/4499)。多因素Cox回归分析结果显示,调整人口社会学特征、生活方式等混杂因素后,以从不吸烟者为参照,戒烟者全因死亡风险增加30.6%[HR(95%CI):1.306(1.043~1.636)];现在吸烟者全因、恶性肿瘤和肺癌死亡风险的HR(95%CI)分别增加50.0%[HR(95%CI):1.500(1.199~1.877)]、80.3%[HR(95%CI):1.803(1.226~2.652)]和212.6%[HR(95%CI):3.126(1.626~6.012)]。吸烟指数与全因、恶性肿瘤和肺癌死亡风险增加呈正向关联,而戒烟年数与相关死亡风险呈负向关联(均P<0.05)。结论北京老年人群吸烟与烟草相关死亡有关联。ObjectiveTo examine the association between smoking status and related mortality among elderly people aged 60 and above in urban and rural areas of Beijing City.MethodsBased on Beijing City Elderly Comprehensive Health Cohort Study from 2009 to 2014,a total of 4499 eligible older adults included in the baseline survey were followed up and investigated to collect information on survival and death.The Cox proportional hazards regression model was used to estimate hazard ratios(HRs)and corresponding 95%confidence intervals(CIs),and the dose-response relationship was estimated between the smoking index,the years of quitting and mortality.ResultsThe median(IQR)age of 4499 subjects was 70.00(10.00)years old,including 1814(40.32%)males.The proportion of non-smokers,former smokers and current smokers was 69.50%(3127/4499),13.20%(594/4499)and 17.30%(778/4499),respectively.After adjusting for confounding factors such as demographic and sociological characteristics,lifestyle,etc.,the results of multivariate Cox regression analysis showed that,compared to non-smokers,former smokers had a 30.6%increased risk of all-cause mortality[HR(95%CI):1.306(1.043-1.636)]and the HR(95%CI)of all-cause,malignant tumor and lung cancer mortality among current smokers has increased by 50.0%[HR(95%CI):1.500(1.199-1.877)],80.3%[HR(95%CI):1.803(1.226-2.652)]and 212.6%[HR(95%CI):3.126(1.626-6.012)],respectively.The smoking index was positively associated with the increased risk of all-cause,malignant tumor and lung cancer mortality,while the years of smoking cessation were negatively associated with that risk(P<0.05).ConclusionSmoking is associated with tobacco-related mortality among elderly people in Beijing City.

关 键 词：老年人 吸烟 队列研究 吸烟戒断 死亡 

分 类 号：R163[医药卫生—公共卫生与预防医学]