Long-Term Effects of Cigarette Smoking on All-Cause Mortality and Cardiovascular Outcomes in Thai Population: Results From a 30-Year Cohort Study

Abstract

Despite the overwhelming evidences on the health consequences of smoking, studies in Asian population in low-to-middle income countries are very limited. Baseline data of a prospective cohort study were collected in year 1985. Endpoints regarding all-cause mortality and major adverse cardiovascular events (MACE) were followed for 30 years. Cox proportional hazard models were used for analysis. Participants had an average age of 43 years, 23% were female, and 43% were current smokers. All-cause mortality was significantly higher in ex-smokers (hazard ratio [HR] 1.32) and current smokers (HR 1.70) when compared with never smokers. Participants with any history of smoking had significantly higher risk of developing MACE. Furthermore, all-cause death, cardiovascular death, and MACE increased with increasing pack years. Statistically significant dose-response relationships were established. Therefore, cigarette smoking increased the risk of all-cause mortality, cardiovascular mortality, and MACE in Thai population. Results emphasized the importance of tobacco control in Thailand.