Smoking and risk of coronary heart disease in younger, middle-aged, and older adults.

Janne S Tolstrup Ulla A Hvidtfeldt Esben Meulengracht Flachs Donna Spiegelman Berit L Heitmann Katarina Bälter Uri Goldbourt Göran Hallmans Paul Knekt Simin Liu Mark Pereira June Stevens Jarmo Virtamo Diane Feskanich

Am J Public Health

Janne S. Tolstrup and Esben Meulengracht Flachs are with the National Institute of Public Health, University of Southern Denmark, Copenhagen. Ulla A. Hvidtfeldt is with the Social Medicine Section, Department of Public Health, University of Copenhagen. Donna Spiegelman and Simin Liu are with the Department of Epidemiology, Harvard School of Public Health, Boston, MA. Berit L. Heitmann is with the Research Unit for Dietary Studies, Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society. Katarina Bälter is with the Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden. Uri Goldbourt is with the Section of Epidemiology and Biostatistics, Henry N. Neufeld Cardiac Research Institute, Department of Epidemiology and Preventive Medicine, Tel Aviv University, Israel. Göran Hallmans is with the Department of Public Health and Clinical Medicine, Umeaa University, Sweden. Paul Knekt and Jarmo Virtamo are with the National Institute for Health and Welfare, Helsinki, Finland. Mark Pereira is with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis. June Stevens is with Department of Nutrition, School of Public Health, University of North Carolina, Chapel Hill. Diane Feskanich is with the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston.

Published: January 2014

Objectives: We investigated associations of smoking and coronary heart disease (CHD) by age.

Methods: Data came from the Pooling Project on Diet and Coronary Heart Disease (8 prospective studies, 1974-1996; n = 192,067 women and 74,720 men, aged 40-89 years).

Results: During follow-up, 4326 cases of CHD were reported. Relative to never smokers, CHD risk among current smokers was highest in the youngest and lowest in the oldest participants. For example, among women aged 40 to 49 years the hazard ratio was 8.5 (95% confidence interval [CI] = 5.0, 14) and 3.1 (95% CI = 2.0, 4.9) among those aged 70 years or older. The largest absolute risk differences between current smokers and never smokers were observed among the oldest participants. Finally, the majority of CHD cases among smokers were attributable to smoking. For example, attributable proportions of CHD by age group were 88% (40-49 years), 81% (50-59 years), 71% for (60-69 years), and 68% (≥ 70 years) among women who smoked.

Conclusions: Among smokers, the majority of CHD cases are attributable to smoking in all age groups. Smoking prevention is important, irrespective of age.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3910023	PMC
http://dx.doi.org/10.2105/AJPH.2012.301091	DOI Listing

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