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      Trends in smoking and lung cancer mortality in Japan, by birth cohort, 1949-2010 Translated title: Tendances du tabagisme et de la mortalité du cancer du poumon au Japon, par cohorte de naissance, 1949-2010 Translated title: Prevalencias del tabaquismo y mortalidad por cáncer de pulmón en Japón por cohorte de nacimiento, 1949-2010

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          Abstract

          OBJECTIVE: To determine smoking trends in Japan in comparison with lung cancer mortality. METHODS: Age-specific smoking prevalence among cohorts born between 1897 and 1985 were determined for the period 1949-2010. The percentages of the cohorts born between 1893 and 1979 who initiated smoking early (e.g. before the age of 20 years) were determined. The results were compared against lung cancer mortality rates in people aged 40-84 years belonging to cohorts born between 1868 and 1968. FINDINGS: In males, smoking prevalence was generally high, particularly among those born before the late 1950s, and early initiation was fairly uncommon. Early initiation was most common among recent birth cohorts of males, who showed relatively low prevalences of smoking. In females, the prevalence of smoking was generally low and early initiation was very uncommon, particularly among those born in the late 1930s and before the late 1940s, respectively. Recent cohorts of females showed relatively high prevalences of smoking and relatively high percentages of early initiation. In both sexes, lung cancer mortality was generally low but increased over the study period. CONCLUSION: Lung cancer mortality in Japanese males was relatively low given the high prevalence of smoking, perhaps because early initiation was fairly uncommon. Over the last four decades, however, early initiation of smoking has become more common in both sexes. The adverse effect this is likely to have on lung cancer mortality rates has probably not been observed because of the long time lag.

          Translated abstract

          OBJECTIF: Déterminer les tendances du tabagisme au Japon comparées à la mortalité par cancer du poumon. MÉTHODES: Les taux de prévalence du tabagisme en fonction de l'âge, parmi les cohortes nées entre 1897 et 1985, ont été déterminés pour la période 1949-2010. Les pourcentages des cohortes nées entre 1893 et 1979, ayant commencé à fumer de manière précoce (par exemple avant l'âge de 20 ans), ont été déterminés. Les résultats ont été comparés aux taux de mortalité par cancer du poumon chez les personnes âgées de 40 à 84 ans, appartenant aux cohortes nées entre 1868 et 1968. RÉSULTATS: Chez les hommes, la prévalence du tabagisme était généralement élevée, en particulier parmi les personnes nées avant les années 1950, et l'initiation précoce était assez peu fréquente. L'initiation précoce était plus fréquente parmi les cohortes de naissances d'hommes, montrant des prévalences relativement faibles de tabagisme. Chez les femmes, la prévalence du tabagisme était généralement faible, et l'initiation précoce très peu fréquente, en particulier chez les personnes nées dans les années 1930 et avant les années 1940, respectivement. Les cohortes récentes de femmes ont montré des prévalences relativement élevées de tabagisme et des pourcentages relativement élevés d'initiation précoce. Pour les deux sexes, la mortalité par cancer du poumon était généralement faible, mais elle a augmenté au cours de la période étudiée. CONCLUSION: La mortalité par cancer du poumon chez les hommes japonais était relativement faible compte tenu de la forte prévalence du tabagisme, peut-être parce que l'initiation précoce était assez rare. Au cours des quatre dernières décennies cependant, l'initiation précoce du tabagisme s'est davantage répandue chez les deux sexes. L'effet négatif que cela peut avoir sur les taux de mortalité par cancer du poumon n'a pas été observé, probablement en raison du décalage.

          Translated abstract

          OBJETIVO: Conocer las prevalencias del tabaquismo en Japón respecto a la mortalidad por cáncer de pulmón. MÉTODOS: Se determinaron los índices de prevalencia del tabaquismo por edad entre cohortes nacidas entre 1897 y 1985 para el periodo 1949-2010. Se establecieron los porcentajes de las cohortes nacidas entre 1893 y 1979 que iniciaron el consumo de tabaco a edad temprana (por ejemplo, antes de los 20 años de edad). Se contrastaron los resultados con los índices de mortalidad por cáncer de pulmón en personas entre los 40 y 84 años de edad que pertenecían a cohortes nacidas entre 1868 y 1968. RESULTADOS: En varones, el índice de prevalencia del tabaquismo resultó ser generalmente alto, particularmente entre aquellos nacidos antes del final de la década de 1950; asimismo, la iniciación temprana fue inusual. Esta resultó ser más común entre las cohortes de nacimiento varones recientes, quienes mostraron una prevalencia del tabaquismo relativamente baja. En mujeres, el índice de prevalencia del tabaquismo resultó ser generalmente bajo y la iniciación temprana fue muy poco común, en particular entre aquellas nacidas a finales de la década de 1930 y antes de finales de la década de 1940, respectivamente. Las cohortes de mujeres recientes mostraron una prevalencia del tabaquismo relativamente alta, así como porcentajes de iniciación temprana relativamente altos. En ambos sexos, la mortalidad por cáncer de pulmón resultó ser generalmente baja, aunque incrementó a lo largo del periodo de estudio. CONCLUSIÓN: La mortalidad por cáncer de pulmón en varones japoneses fue relativamente baja, si se compara con la alta prevalencia del tabaquismo. Quizá esto se deba a que la iniciación temprana fue poco común. No obstante, en las últimas cuatro décadas la iniciación temprana al tabaquismo es más común en ambos sexos. Posiblemente, no se ha observado el efecto adverso que esto pueda tener sobre los índices de mortalidad por cáncer de pulmón debido al gran lapso temporal.

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          Smoking in China: findings of the 1996 National Prevalence Survey.

          As the world's largest producer and consumer of tobacco products, China bears a large proportion of the global burden of smoking-related disease and may be experiencing a tobacco epidemic. To develop an evidence-based approach supporting tobacco control initiatives in China. A population-based survey consisting of a 52-item questionnaire that included information on demographics, smoking history, smoking-related knowledge and attitudes, cessation, passive smoke exposure, and health status was administered in 145 disease surveillance points in the 30 provinces of China from March through July 1996. A nationally representative random sample of 128766 persons aged 15 to 69 years were asked to participate; 120298 (93.8%) provided data and were included in the final analysis. About two thirds of those sampled were from rural areas and one third were from urban areas. Current smoking patterns and attitudes; changes in smoking patterns and attitudes compared with results of a previous national survey conducted in 1984. A total of 41187 respondents smoked at least 1 cigarette per day, accounting for 34.1% of the total number of respondents, an increase of 3.4 percentage points since 1984. Current smoking continues to be prevalent among more men (63%) than women (3.8%). Age at smoking initiation declined by about 3 years for both men and women (from 28 to 25 years). Only a minority of smokers recognized that lung cancer (36%) and heart disease (4%) can be caused by smoking. Of the nonsmokers, 53.5% were exposed to environmental tobacco smoke at least 15 minutes per day on more than 1 day per week. Respondents were generally supportive of tobacco control measures. The high rates of smoking in men found in this study signal an urgent need for smoking prevention and cessation efforts; tobacco control initiatives are needed to maintain or decrease the currently low smoking prevalence in women.
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              Lung cancer death rates in lifelong nonsmokers.

              Few studies have directly measured the age-, sex-, and race-specific risks of lung cancer incidence and mortality among never tobacco smokers. Such data are needed to quantify the risks associated with smoking and to understand racial and sex disparities and temporal trends that are due to factors other than active smoking. We measured age-, sex-, and race-specific rates (per 100,000 person-years at risk) of death from lung cancer among more than 940,000 adults who reported no history of smoking at enrollment in either of two large American Cancer Society Cancer Prevention Study cohorts during 1959-1972 (CPS-I) and 1982-2000 (CPS-II). We compared lung cancer death rates between men and women and between African Americans and whites and analyzed temporal trends in lung cancer death rates among never smokers across the two studies by using directly age-standardized rates as well as Poisson and Cox proportional hazards regression analyses. All statistical tests were two-sided. The age-standardized lung cancer death rates among never-smoking men and women in CPS-II were 17.1 and 14.7 per 100,000 person-years, respectively. Men who had never smoked had higher age-standardized lung cancer death rates than women in both studies (CPS-I: hazard ratio [HR] = 1.52, 95% confidence interval [CI] = 1.28 to 1.79; CPS-II: HR = 1.21, 95% CI = 1.09 to 1.36). The rate was higher among African American women than white women in CPS-II (HR = 1.43, CI = 1.11 to 1.85). A small temporal increase (CPS-II versus CPS-I) in lung cancer mortality was seen for white women (HR = 1.25, CI = 1.12 to 1.41) and African American women (HR = 1.22, CI = 0.64 to 2.33), but not for white men (HR = 0.89, CI = 0.74 to 1.08). Among white and African American women combined, the temporal increase was statistically significant only among those aged 70-84 years (P < .001). Contrary to clinical perception, the lung cancer death rate is not higher in female than in male never smokers and shows little evidence of having increased over time in the absence of smoking. Factors that affect the interpretation of lung cancer trends are discussed. Our novel finding that lung cancer mortality is higher among African American than white women never smokers should be confirmed in other studies.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                bwho
                Bulletin of the World Health Organization
                Bull World Health Organ
                World Health Organization (Genebra )
                0042-9686
                May 2013
                : 91
                : 5
                : 332-340
                Affiliations
                [1 ] Teikyo University Graduate Japan
                [2 ] Chugai Pharmaceutical Company Japan
                Article
                S0042-96862013000500008
                10.2471/BLT.12.108092
                3646352
                23678196
                0183daf1-f229-401f-9ecc-3577416b2c51

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Public Health

                Self URI (journal page): http://www.scielosp.org/scielo.php?script=sci_serial&pid=0042-9686&lng=en
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                Public health
                Public health

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