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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Does Smoking Reduction in Midlife Reduce Mortality Risk? Results of 2 Long-Term Prospective Cohort Studies of Men and Women in Scotland
Author(s): Hart, Carole
Gruer, Laurence
Bauld, Linda
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Keywords: cohort studies
harm reduction
smoking cessation
Issue Date: Sep-2013
Date Deposited: 21-Feb-2014
Citation: Hart C, Gruer L & Bauld L (2013) Does Smoking Reduction in Midlife Reduce Mortality Risk? Results of 2 Long-Term Prospective Cohort Studies of Men and Women in Scotland. American Journal of Epidemiology, 178 (5), pp. 770-779.
Abstract: A long-term cohort study of working men in Israel found that smokers who reduced their cigarette consumption had lower subsequent mortality rates than those who did not. We conducted comparable analyses in 2 populations of smokers in Scotland. The Collaborative Study included 1,524 men and women aged 40-65 years in a working population who were screened twice, in 1970-1973 and 1977. The Renfrew/Paisley Study included 3,730 men and women aged 45-64 years in a general population who were screened twice, in 1972-1976 and 1977-1979. Both groups were followed up through 2010. Subjects were categorized by smoking intensity at each screening as smoking 0, 1-10, 11-20, or ≥21 cigarettes per day. At the second screening, subjects were categorized as having increased, maintained, or reduced their smoking intensity or as having quit smoking between the first and second screenings. There was no evidence of lower mortality in all reducers compared with maintainers. Multivariate adjusted hazard ratios of mortality were 0.91 (95% confidence interval (CI): 0.75, 1.10) in the Collaborative Study and 1.08 (95% CI: 0.97, 1.20) in the Renfrew/Paisley Study. There was clear evidence of lower mortality among quitters in both the Collaborative Study (hazard ratio = 0.66, 95% CI: 0.56, 0.78) and the Renfrew/Paisley Study (hazard ratio = 0.75, 95% CI: 0.67, 0.84). In the Collaborative Study only, we observed lower mortality similar to that of quitters among heavy smokers (≥21 cigarettes/day) who reduced their smoking intensity. These inconclusive results support the view that reducing cigarette consumption should not be promoted as a means of reducing mortality, although it may have a valuable role as a step toward smoking cessation.
DOI Link: 10.1093/aje/kwt038
Rights: © The Author 2013. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
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