The relation of environmental tobacco smoke (ETS) to chronic bronchitis and mortality over two decades

Introduction: Our aim was to describe how the prevalence of subjects exposed to environmental tobacco smoke (ETS) has changed from 1992 to 2012 in Finland. We also investigated the association between ETS and chronic bronchitis and cause-specific and all-cause mortality. Methods: The study population is composed of 38 494 subjects aged 25-74 years who participated in the National FINRISK Study between 1992 and 2012. Each survey included a standardized questionnaire on exposure to ETS, symptoms of chronic bronchitis, smoking habits and other risk factors, and clinical measurements at the study site. Data on mortality was obtained from the National Causes of Death Register. Results: In 2012, 5% of the participants were exposed to ETS compared to 25% in 1992. The adjusted odds ratio (OR) for ETS exposure in 2012 compared with that in 1992 was 0.27, p <0.001. Exposure to ETS was more common in men than in women and among smokers than in non-smokers. Exposure to ETS was in turn associated with chronic bronchitis, OR 1.63 (95% confidence interval 1.49-1.78),-also separately both at work (OR 1.36) and at home (OR 1.69). Subjects with exposure to ETS had significantly increased all-cause (hazard ratio=HR 1.15, 1.05-1.26) and cardiovascular mortality (HR 1.26, 1.07-1.47). However, when stratified by smoking ETS was associated with all-cause mortality only in smokers (HR 1.31, 1.15-1.48). Conclusion: The proportion of subjects exposed to ETS decreased substantially during the study. Additionally, ETS exposure was associated with chronic bronchitis throughout the study and increased all-cause and cardiovascular mortality.Peer reviewe

Smoking and cancer, cardiovascular and total mortality among older adults: The Finrisk Study

Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habits with cancer, CVD and all-cause mortality in late middle-age (45–64 years) and older (65–74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997–2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of Death Register and data on incident stroke events from the National Hospital Discharge Register. Adjusted Hazard ratios (HR) for total mortality were 2.61 (95% Confidence interval 2.15–3.18) among 45–64 years-old men and 2.59 (2.03–3.29) in 65–74 years-old men. The corresponding HRs for women 45–64 years-of-age were 3.21 (2.47–4.19) and 3.12 (2.09–4.68) for those 65–74 years-old, respectively. Adjusted HRs for CVD mortality in the 45–64 years-old and 65–74 years-old groups were 2.67 (1.92–2.67) and 1.95 (1.33–2.86) in men, and 4.28 (2.29–7.99) and 2.67 (1.28–5.58) in women, respectively. Among men, the risk difference between never and current smokers was 108/100.000 in the age-group 45–64 years, and 324/100.000 in the age group 65–74 years. Among women the differences were 52/100.000 and 196/100.000, respectively. In conclusion, absolute risk difference between never and current smokers are larger among the older age group. Smoking cessation counseling should routinely target also older adults in primary health-care.Peer reviewe