What is the clinical evidence from this study?

Study design: Cohort. Population: Low-intensity smoking (n=290215). Intervention: Low-intensity smoking (<1 or 1-10 cigarettes per day) vs. Never smoking. Primary outcome: All-cause mortality (HR 1.64, 95% CI 1.07-2.51).

What question did this study set out to answer?

To evaluate the associations of lifelong low-intensity smoking (<1 or 1–10 cigarettes per day) with all-cause and cause-specific mortality compared to never smoking.

December 5, 2016JAMA Internal MedicineOpen Access

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

Q: What are the key findings of this study?

Consistent smoking of <1 or 1-10 cigarettes per day increased all-cause mortality risk compared to never smoking (HR 1.64, 95% CI 1.07-2.51 and HR 1.87, 95% CI 1.64-2.13).

Q: What does this research mean for the field?

Consistent long-term smoking of fewer than 1 or 1 to 10 cigarettes per day significantly increases the risk of all-cause and cause-specific mortality compared to never smoking. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

Q: What question did this study set out to answer?

To evaluate the associations of lifelong low-intensity smoking (<1 or 1–10 cigarettes per day) with all-cause and cause-specific mortality compared to never smoking.

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Key result

Consistent smoking of <1 or 1-10 cigarettes per day increased all-cause mortality risk compared to never smoking (HR 1.64, 95% CI 1.07-2.51 and HR 1.87, 95% CI 1.64-2.13).

Why the study?

Does long-term, low-intensity smoking increase all-cause and cause-specific mortality compared to never smoking in older adults?

Key Points

To evaluate the associations of lifelong low-intensity smoking (<1 or 1–10 cigarettes per day) with all-cause and cause-specific mortality compared to never smoking.
Prospective cohort study analyzing 290,215 adults aged 59 to 82 years in the NIH-AARP Diet and Health Study with smoking history assessed across 9 lifetime age periods.
Calculated hazard ratios (HRs) and 95% CIs for mortality through 2011 using Cox proportional hazards regression models adjusted for age, sex, race/ethnicity, education, physical activity, and alcohol intake.
Consistent lifetime smokers of <1 CPD (HR, 1.64; 95% CI, 1.07–2.51) and 1–10 CPD (HR, 1.87; 95% CI, 1.64–2.13) had higher all-cause mortality risks relative to never smokers.
Lung cancer mortality was markedly elevated for consistent smokers of <1 CPD (HR, 9.12; 95% CI, 2.92–28.47) and 1–10 CPD (HR, 11.61; 95% CI, 8.25–16.35).
Smoking cessation at younger ages progressively lowered mortality risks, with cessation at age ≥50 years yielding HRs of 1.44 (95% CI, 1.12–1.85) for <1 CPD and 1.42 (95% CI, 1.27–1.59) for 1–10 CPD.

Study Design

Type

Cohort (n=290,215)

Structured PICO

Does long-term, low-intensity smoking increase all-cause and cause-specific mortality compared to never smoking in older adults?

Population

290,215 adults aged 59 to 82 years (mean age 71, 57.9% male) in the National Institutes of Health-AARP Diet and Health Study.

Intervention

Long-term, low-intensity smoking (consistently smoking fewer than 1 or 1 to 10 cigarettes per day over lifetime).

Comparator

Never smoking cigarettes.

Outcome

All-cause and cause-specific mortality through the end of 2011.hard clinical

Main Result

Effect estimate: HR 1.64 (95% CI 1.07-2.51)

Even low-intensity smoking (<1 or 1-10 cigarettes per day) over a lifetime significantly increases the risk of all-cause and cause-specific mortality compared to never smoking, emphasizing that there is no risk-free level of tobacco exposure.

Discussion

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Implication

Low-intensity smoking was associated with higher mortality; leaves open whether cessation benefits apply at this exposure level.

Cite This Study

Inoue‐Choi et al. (2016) conducted a cohort in Low-intensity smoking (n=290,215). Low-intensity smoking (<1 or 1-10 cigarettes per day) vs. Never smoking was evaluated on All-cause mortality (HR 1.64, 95% CI 1.07-2.51). Consistent smoking of <1 or 1-10 cigarettes per day increased all-cause mortality risk compared to never smoking (HR 1.64, 95% CI 1.07-2.51 and HR 1.87, 95% CI 1.64-2.13).

synapsesocial.com/papers/6a1534ab814bf8ec9a4e3bd3 https://doi.org/10.1001/jamainternmed.2016.7511

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Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Association of Long-term, Low-Intensity Smoking With All-Cause and Cause-Specific Mortality in the National Institutes of Health–AARP Diet and Health Study

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider