Abstract
Many women smoke, yet few longitudinal studies have examined the non-fatal burden of smoking in women.
Aim
To investigate smoking in young women, and hospital admission and death in Scotland; and to compare mortality risk with elsewhere in the UK.
Design and setting
Nested cohort study: Royal College of General Practitioners' Oral Contraception Study, UK.
Method
A total of 4121 women categorised by smoking habits and living in Scotland at recruitment (1968-1969) were followed until March 2009. Cox regression was used to investigate smoking and survival time; mortality from cancer, circulatory, or respiratory disease, and all other causes; and hospitalisation for any reason, and for specific reasons. The number and type of hospital admissions and bed-days were examined by smoking status. Life tables and Cox regression were used to compare the mortality risk of women living in Scotland with that of women living elsewhere.
Results
All-cause mortality was increased in women who smoked <15 cigarettes daily (adjusted hazard ratio = 1.99, 95% confidence interval [CI] = 1.74 to 2.27) and those who smoked ≥15 cigarettes daily (adjusted HR = 2.81, 95% CI = 2.47 to 3.20). Smoking any amount increased death from cancer, circulatory, respiratory, and other causes. Increased risk estimates were seen in one or both smoking groups for hospitalisation for any cause, and for several specific causes. More smokers than non-smokers were admitted to hospital, for four or more reasons, and had a longer total stay. The median survival age among smokers was lower in Scotland than elsewhere. Higher adjusted hazard ratios for mortality were found among smokers in Scotland.
Conclusion
This study provides a powerful reminder of the burden of smoking in young women. In the UK, harmful effects appear to be worse in smokers in Scotland.
| Original language | English |
|---|---|
| Pages (from-to) | 523-533 |
| Number of pages | 11 |
| Journal | The British Journal of General Practice |
| Volume | 63 |
| Issue number | 613 |
| DOIs | |
| Publication status | Published - Aug 2013 |
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Keywords
- cohort studies
- general practice
- hospitalisation
- mortality
- smoking
- women
Cite this
Smoking in young women in Scotland and future burden of hospital admission and death : a nested cohort study. / Iversen, Lisa; Fielding, Shona ; Hannaford, Philip C.
In: The British Journal of General Practice, Vol. 63, No. 613, 08.2013, p. 523-533.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Smoking in young women in Scotland and future burden of hospital admission and death
T2 - a nested cohort study
AU - Iversen, Lisa
AU - Fielding, Shona
AU - Hannaford, Philip C
PY - 2013/8
Y1 - 2013/8
N2 - BackgroundMany women smoke, yet few longitudinal studies have examined the non-fatal burden of smoking in women.AimTo investigate smoking in young women, and hospital admission and death in Scotland; and to compare mortality risk with elsewhere in the UK.Design and settingNested cohort study: Royal College of General Practitioners' Oral Contraception Study, UK.MethodA total of 4121 women categorised by smoking habits and living in Scotland at recruitment (1968-1969) were followed until March 2009. Cox regression was used to investigate smoking and survival time; mortality from cancer, circulatory, or respiratory disease, and all other causes; and hospitalisation for any reason, and for specific reasons. The number and type of hospital admissions and bed-days were examined by smoking status. Life tables and Cox regression were used to compare the mortality risk of women living in Scotland with that of women living elsewhere.ResultsAll-cause mortality was increased in women who smoked <15 cigarettes daily (adjusted hazard ratio = 1.99, 95% confidence interval [CI] = 1.74 to 2.27) and those who smoked ≥15 cigarettes daily (adjusted HR = 2.81, 95% CI = 2.47 to 3.20). Smoking any amount increased death from cancer, circulatory, respiratory, and other causes. Increased risk estimates were seen in one or both smoking groups for hospitalisation for any cause, and for several specific causes. More smokers than non-smokers were admitted to hospital, for four or more reasons, and had a longer total stay. The median survival age among smokers was lower in Scotland than elsewhere. Higher adjusted hazard ratios for mortality were found among smokers in Scotland.ConclusionThis study provides a powerful reminder of the burden of smoking in young women. In the UK, harmful effects appear to be worse in smokers in Scotland.
AB - BackgroundMany women smoke, yet few longitudinal studies have examined the non-fatal burden of smoking in women.AimTo investigate smoking in young women, and hospital admission and death in Scotland; and to compare mortality risk with elsewhere in the UK.Design and settingNested cohort study: Royal College of General Practitioners' Oral Contraception Study, UK.MethodA total of 4121 women categorised by smoking habits and living in Scotland at recruitment (1968-1969) were followed until March 2009. Cox regression was used to investigate smoking and survival time; mortality from cancer, circulatory, or respiratory disease, and all other causes; and hospitalisation for any reason, and for specific reasons. The number and type of hospital admissions and bed-days were examined by smoking status. Life tables and Cox regression were used to compare the mortality risk of women living in Scotland with that of women living elsewhere.ResultsAll-cause mortality was increased in women who smoked <15 cigarettes daily (adjusted hazard ratio = 1.99, 95% confidence interval [CI] = 1.74 to 2.27) and those who smoked ≥15 cigarettes daily (adjusted HR = 2.81, 95% CI = 2.47 to 3.20). Smoking any amount increased death from cancer, circulatory, respiratory, and other causes. Increased risk estimates were seen in one or both smoking groups for hospitalisation for any cause, and for several specific causes. More smokers than non-smokers were admitted to hospital, for four or more reasons, and had a longer total stay. The median survival age among smokers was lower in Scotland than elsewhere. Higher adjusted hazard ratios for mortality were found among smokers in Scotland.ConclusionThis study provides a powerful reminder of the burden of smoking in young women. In the UK, harmful effects appear to be worse in smokers in Scotland.
KW - cohort studies
KW - general practice
KW - hospitalisation
KW - mortality
KW - smoking
KW - women
U2 - 10.3399/bjgp13X670651
DO - 10.3399/bjgp13X670651
M3 - Article
VL - 63
SP - 523
EP - 533
JO - The British Journal of General Practice
JF - The British Journal of General Practice
SN - 0960-1643
IS - 613
ER -