Smoking: stopping reduced the risk of dying early

Clinical bottom line (level 1b)

  1. Men with a low FEV 1 were at increased risk of dying early.
  2. Men who stop smoking reduced their risk of dying early.
Pelkonen et al: Thorax 2000; 55 : 746-750
Expires October 2003

The study

Prospective cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: 2 rural areas, Finland

1582 patients (aged 40 to 59, 100% male) who were smokers at enrollment in the Seven Counties study

Excluded if
  • incomplete data required for multivariate analysis


    Factors studied:
  • age, BMI, diastolic blood pressure, total cholesterol, number of cigarettes smoked per day
  • FEV1 - lowest third




  • Cox proportional regression analysis was used to adjust for confounding factors.

    100% followed for 40 years
    Outcomes studied:
  • death

    The evidence

    outcome time to outcome number of patients/total number %
    (95% CI)
    death 40 years 1086/1582 69%
    (66% to 71%)

    prognostic factor for
    death     		time to outcome control rate (%) adjusted OR
    (95% CI)    		 NNF+
    (95% CI)
    FEV1 - lowest third ? 1086/1582
    (69%)     		1.56
    (1.35 to 1.81)     		11
    (9 to 16)

    • Hazard ratio for death: quitters v. continuous smokers: 0.71 (95% CI: 0.50 to 1.0)

    Citation

    1. Pelkonen M, Tukiainen H, Tervahauta M, et al: pulmonary function, smoking cessation and 30 year mortality in middle aged Finnish men. Thorax 2000; 55 : 746-750
    Search Terms: from ACP Journal Club other articles noted
    Contributor: Chris Ball, October 2001
    Reviewer:

    Clinical Question.
    Patient men
    Intervention or Exposure FEV1, stopped smoking
    Outcome death
    		•