Stages of the cigarette epidemic on entering its second century.

Objectives: A four-stage model of the cigarette epidemic was proposed in 1994 to communicate the long delay between the widespread uptake of cigarette smoking and its full effects on mortality, as had been experienced in economically developed countries where cigarette smoking became entrenched decades earlier in men than in women. In the present work, the question of whether qualitative predictions from the model have matched recent trends in smoking and deaths from smoking in countries at various levels of economic development is assessed, and possible projections to the year 2025 are considered.

Methods: The proportion of all deaths attributed to tobacco was estimated indirectly for 41 high-resource and medium-resource countries from 1950 to the most recent year for which data were available, generally about 2005-2009.

Body mass index and chronic obstructive pulmonary disease-related mortality: a nationally representative prospective study of 220,000 men in China.

Background: Low body mass index (BMI) is associated with chronic obstructive pulmonary disease (COPD) in populations where many are overweight. Substantial uncertainty remains about the relationship in populations with lower mean BMI levels, and about the relevance to it of the effects of smoking or of reverse causality.

Methods: A nationally representative prospective cohort study included 221,194 Chinese men aged 40-79 years in 1990-91, who were followed up for 15 years or to the age of 80 years.

Body mass index and mortality from lung cancer in smokers and nonsmokers: a nationally representative prospective study of 220,000 men in China.

Low body mass index (BMI) has been associated with increased risk of lung cancer. However, the nature of the association, especially in populations with relatively low BMI, is less well characterized, as is the relevance to it of smoking. A nationally representative prospective cohort study included 217,180 Chinese men aged 40-79 years in 1990-91 who had no prior history of cancer and were followed up for 15 years.

Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths.

Background: Alcohol is an important determinant of the high and fluctuating adult mortality rates in Russia, but cause-specific detail is lacking. Our case-control study investigated the effects of alcohol consumption on male and female cause-specific mortality.

Methods: In three Russian industrial cities with typical 1990s mortality patterns (Tomsk, Barnaul, Biysk), the addresses of 60,416 residents who had died at ages 15-74 years in 1990-2001 were visited in 2001-05.

Alcohol poisoning is a main determinant of recent mortality trends in Russia: evidence from a detailed analysis of mortality statistics and autopsies.

Background: The changes in Russian mortality rates during the last two decades are unprecedented in a modern industrialized country. Although these fluctuations have attracted much interest, trends for major groups of causes of death have been analysed while trends in specific causes of death might shed light on the underlying determinants.

Methods: We analysed trends in total and cause-specific mortality in Russia for 1991-2006.

A nationally representative case-control study of smoking and death in India.

Background: The nationwide effects of smoking on mortality in India have not been assessed reliably.

Methods: In a nationally representative sample of 1.1 million homes, we compared the prevalence of smoking among 33,000 deceased women and 41,000 deceased men (case subjects) with the prevalence of smoking among 35,000 living women and 43,000 living men (unmatched control subjects).

Social inequalities in male mortality, and in male mortality from smoking: indirect estimation from national death rates in England and Wales, Poland, and North America.

Background: There are substantial social inequalities in adult male mortality in many countries. Smoking is often more prevalent among men of lower social class, education, or income. The contribution of smoking to these social inequalities in mortality remains uncertain.

Smoking and cardiovascular disease.

Tobacco, especially cigarette, smoking is a major cause of cardiovascular disease (CVD), responsible for about one third of all CVD deaths in most Western populations. The risk of CVD death increases with increasing exposure to cigarette smoke, as measured by the number of cigarettes smoked daily, the duration of smoking, the degree of inhalation and the age of initiation. The relative risk for CVD is substantially greater in early adult life than in old age, and is associated more strongly with cigarettes than with other types of tobacco.

Recent trends in cancer mortality in the UK.

Comparisons of survival rates of given diseases with different treatments or in different places often gave misleading results until the introduction of controlled trials. Recent reports of relatively low survival rates following the treatment of cancer in the UK compared to the rates in other countries, not based on controlled trials, may consequently be misleading. Their validity has, therefore, been tested by comparing the levels and trends in mortality--the ultimate criterion by which the success or failure of any system of care can be judged.

Mortality from cancer in relation to smoking: 50 years observations on British doctors.

A total of 34,439 male British doctors, who reported their smoking habits in November 1951, were followed, with periodic up date of changes in their habits, until death, emigration, censoring. or November 2001. Information was obtained about their mortality from 28 of the 30 types of cancer in men reviewed by the International Agency for Research on Cancer (no death was recorded from the other two).

Mortality in relation to alcohol consumption: a prospective study among male British doctors.

Background: To relate alcohol consumption patterns to mortality in an elderly population.

Methods: We undertook a 23-year prospective study of 12 000 male British doctors aged 48-78 years in 1978, involving 7000 deaths. Questionnaires about drinking and smoking were completed in 1978 and once again in 1989-91.

Mortality in relation to smoking: 50 years' observations on male British doctors.

Objective: To compare the hazards of cigarette smoking in men who formed their habits at different periods, and the extent of the reduction in risk when cigarette smoking is stopped at different ages.

Design: Prospective study that has continued from 1951 to 2001.

Setting: United Kingdom.

Smoking and liver cancer in China: case-control comparison of 36,000 liver cancer deaths vs. 17,000 cirrhosis deaths.

Liver cancer and liver cirrhosis are common causes of death in China, where chronic lifelong hepatitis B infection is a major cause of both diseases. To help determine whether smoking is a cofactor for the development of liver cancer, we ascertained retrospectively the smoking habits of 36,000 adults who had died from liver cancer (cases) and 17,000 who had died from cirrhosis (controls) in 24 Chinese cities and 74 rural counties. Calculations of the smoker vs.

Smoking and dementia in male British doctors: prospective study.

Objective: To assess the possible association between smoking and dementia.

Design: Prospective study.

Setting: Cohort of British male doctors followed up since 1951.

Emerging tobacco hazards in China: 2. Early mortality results from a prospective study.

Objective: To monitor the evolving epidemic of mortality from tobacco in China following the large increase in male cigarette use in recent decades.

Design: Prospective study of smoking and mortality starting with 224 500 interviewees who should eventually be followed for some decades.

Setting: 45 nationally representative small urban or rural areas distributed across China.

Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths.

Objective: To assess the hazards at an early phase of the growing epidemic of deaths from tobacco in China.

Design: Smoking habits before 1980 (obtained from family or other informants) of 0.7 million adults who had died of neoplastic, respiratory, or vascular causes were compared with those of a reference group of 0.

Mortality from smoking worldwide.

Estimates are made of the numbers and proportions of deaths attributable to smoking in 44 developed countries in 1990. In developed countries as a whole, tobacco was responsible for 24% of all male deaths and 7% of all female deaths, rising to over 40% in men in some former socialist economies and 17% in women in the USA. The average loss of life for all cigarette smokers was about 8 years and for those whose deaths were attributable to tobacco about 16 years.

Geographic association between urinary excretion of N-nitroso compounds and oesophageal cancer mortality in China.

Overnight urine samples were collected from approximately 60 male adults in each of 69 counties of China in 1989. Two specimens were collected from each subject--one after a loading dose of proline and ascorbic acid and another after a loading dose of proline only. Levels of N-nitrosamino acids and nitrate were measured in urine samples and correlated with cumulative mortality rates for subjects aged between 0 and 64 years in the 1970s.