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目的 :评估在中国由烟草所致的死亡增长早期阶段的危害状况。设计 :对死于肿瘤、呼吸道疾病和 (或 )血管疾病的 70万成年人和死于其他疾病的 2 0万参照人群的 80年代前的吸烟习惯进行分析比较。地区 :中国的 2 4个大城市和 74个农村县。对象 :对 1986～ 1988年间死亡的 10 0万例死者家属进行家访调查。主要结果测定 :中老年期因烟草所致的肿瘤、呼吸道疾病和血管疾病死亡率。结果 :在 3 5～ 69岁的男性吸烟者中 ,肿瘤超额死亡为 5 1% (标准误为 2 ) ,呼吸道疾病超额死亡 3 1% ( 2 ) ,血管疾病超额死亡 15 % ( 2 )。这三者的超额死亡均有显著性意义 (P <0 .0 0 0 1)。在 70岁及以上的吸烟男性 ,肿瘤超额死亡为 5 4 % ( 2 ) ,呼吸道疾病超额死亡 15 % ( 2 ) ,血管疾病超额死亡 6% ( 2 )。虽然女性吸烟者较少 ,但吸烟女性肺癌和呼吸道疾病的归因危险性与男性相似。虽然 ,3 5～ 69岁吸烟男女的肺癌死亡率均约为不吸烟者的 3倍 ,但由于不同地区非吸烟者中的肺癌死亡率差异较大 ,因此 ,中国各地区吸烟所致肺癌的超额死亡绝对数差异很大 ,由烟草所致的死亡中 ,慢性阻塞性肺病占 4 5 % ,肺癌占 15 % ,食管癌、胃癌、肝癌、结核、脑卒中和缺血性心脏病各占 5 %～ 8%。 1990年在中国烟草造成约 60万人死亡 (男性占
Purpose: To assess the status of the harms caused by the early stage of the tobacco-induced death in China. Design: An analysis of pre-80s smoking habits among 700,000 adults who died of cancer, respiratory disease, and / or vascular disease and 20 million reference populations who died of other illnesses. Regions: 24 large cities and 74 rural counties in China. PARTICIPANTS: A family visit survey was conducted on the families of the 100 000 deceased people who died between 1986 and 1988. Main Outcome Measures: Mortality from tobacco-induced tumors, respiratory diseases and vascular diseases in middle-aged and older people. RESULTS: Out of male smokers aged 35-69 years, the excess cancer death was 51% (standard error 2), excess mortality was 31% (2), and vascular death was 15% (2). The excess deaths of the three groups were all significant (P <0.0001). Among smokers aged 70 and over, the number of cancer deaths was 54% (2), respiratory disease deaths were 15% (2), and vascular disease deaths were 6% (2). Although there are fewer female smokers, the risk of at-risk lung cancer and respiratory disease in women who smoke is similar to that of men. Although lung cancer death rates among smoking males and females aged 35-69 are about three times those of non-smokers, lung cancer mortality varies greatly among non-smokers in different regions. Therefore, the excess lung cancer caused by smoking in various regions of China The absolute number of deaths varies widely. Of the deaths caused by tobacco, COPD accounts for 45%, lung cancer accounts for 15%, esophageal cancer, stomach cancer, liver cancer, tuberculosis, stroke and ischemic heart disease account for 5% ~ 8%. About 60 million people died of tobacco in China in 1990 (men accounted for