redstar2000

Ok, Dr. Rick, I think I have enough to go on here...but you can check my math and make sure I didn't misunderstand something.

Looking at the original study you quoted, out of 14,697 patients diagnosed with coronary heart disease, 1,055 died from the disease over a six-year period...that would be about one in thirteen. Current smokers did fare worse: about one in ten succumbed to that disease.

Can that be right? Did I correctly extract the real odds from the data?

And if I did, then I would have to go through a veritible mountain of studies to get any real idea of what the true risk of tobacco use really is...because the studies are all interested in reporting "increased risk" but not with any numerical "base line" to compare it to.

If the "puritan" has a death rate of 1 in a 1000 and the "libertine" has a death rate of 10 in a 1000, the ratio is a staggering 10.0! But 99 out of 100 libertines will have a good time without consequences. The ratio is reported; the true risk must be painfully extracted and goes unpublicized.

Not to sound "cynical", but is there something about the way research grants are allocated that could be responsible for this?

Mad Kally

Forget all those mountains of studies and just go to the nearest hospital with a cancer floor and walk around, look, and ask a few questions. I mean like, do you really believe smoking is NOT harmful? That reminds me of the guy who blamed McDonalds because he was obese.

redstar2000

Mad Kally, I don't question the evidence that smoking is harmful...my question is how harmful? What are the true numerical odds?

Your suggested "research method" is useless; if the only automobile drivers and passengers that I ever met were to be found in hospital emergency rooms...then I would conclude that the rational course is never to get into an automobile under any circumstances...it is 100% certain to result in injury or death.

But that would be wrong, wouldn't it?

Mad Kally

Then start going through the mountains of studies.

Nuno Figueira

What's the point? You know it causes cancer and many other diseases, it contributes to a great deal of CVD's that plague modern mankind, it hurts "innocent" people's health, what more do you need? If you want numbers just go get them. It's nothing a few googles won't come up with.

Oxymoron

Like you're really interested. Look, just suppose you found that the odds were 1 in N of contracting any life or quality-of-life threatening condition. What would that actually mean? Could you tell if you were the '1' out of those N people? No, you could not. And just so long as you can keep questioning the stats and the lack of a definitive answer, you'll never have to face the fact that you might have, ever so slowly, commited suicide.

Quote:

Your suggested "research method" is useless; if the only automobile drivers and passengers that I ever met were to be found in hospital emergency rooms...then I would conclude that the rational course is never to get into an automobile under any circumstances...it is 100% certain to result in injury or death. But that would be wrong, wouldn't it?

Go on, deliberately misunderstand the nature of stats and risk if it makes you feel better.

Wyz_sub10

My wife's aunt is dying from long cancer. She is in a palliative care ward as I type. Never smoked a day in her life. Husband did, though.

redstar2000

Oxymoron, instead of nagging me about what a "sinner" I am, couldn't you just "pray" for me...silently?

Oxymoron

I make no judgement about you, redstar2000. I don't know you from Adam (the guy next door who smokes). It is your arguments and reasoning that I take issue with. If you don't want to debate ideas - especially important and personal ones - then you are in a strange place, here in the IIDF!

Dr Rick

Arch Intern Med 1999 Apr 12;159(7):733-40

Cigarette smoking and mortality risk: twenty-five-year follow-up of the Seven Countries Study.

Jacobs DR Jr, Adachi H, Mulder I, Kromhout D, Menotti A, Nissinen A, Blackburn H.

Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454, USA. jacobs@epivax.epi.umn.edu

BACKGROUND: Although most observations in the Seven Countries Study suggest that cigarette smoking is harmful for health, universality of this conclusion remains controversial. SUBJECTS AND METHODS: Cohort-specific and pooled smoking habits at baseline (1957-1964) in 12 763 men aged 40 through 59 years living in Europe, the United States, and Japan in relation to 25-year mortality follow-up. Pooled hazard ratios for smokers vs never smokers were calculated by the Cox proportional hazards model, adjusting for baseline country of residence, age, body mass index, serum cholesterol, systolic blood pressure, and clinical cardiovascular disease. RESULTS: Adjusted hazard ratios for all-causes death in smokers compared with never smokers were 1.3 (95% confidence interval, 1.2-1.4) for smokers of less than 10 cigarettes per day and 1.8 (95% confidence interval, 1.7-1.9) for smokers of 10 cigarettes per day or more. Hazard ratios were elevated for death due to coronary heart disease, all stroke, other arterial disease, lung cancer, other cancer, chronic obstructive pulmonary disease, and other disease in smokers compared with never smokers. Within country, a few instances in which never smokers had a higher cause-specific death rate than smokers of 10 cigarettes per day or more were attributable to random variation associated with low prevalence of never smokers and multiple comparisons. CONCLUSIONS: These findings confirm the association of cigarette smoking with elevated risk of mortality from all causes, several cardiovascular diseases, cancer, and chronic obstructive pulmonary disease. Risk associated with cigarette smoking is independent of culture.


JAMA 1997 Nov 12;278(18):1505-8

Mortality attributable to cigarette smoking in China.

Lam TH, He Y, Li LS, Li LS, He SF, Liang BQ.

Department of Community Medicine, University of Hong Kong, China. hrmrlth@hkucc.hku.hk

CONTEXT: The few published prospective studies of smoking and mortality in China have reported low relative risks, but the durations of follow-up were short. OBJECTIVE: To assess the mortality of ever- and never-smokers in a cohort after 20 years of follow-up. DESIGN, SETTING, AND SUBJECTS: A cohort analytic study in a machinery factory in Xi'an, China, involving 1696 people aged 35 years or older (1124 men and 572 women) examined in May 1976. MAIN OUTCOME MEASURES: All-cause and tobacco-associated mortality. RESULTS: A total of 56% of the men and 12% of the women were ever-smokers at baseline. Through August 31, 1996, 218 persons (173 men and 45 women) had died. The relative risks (95% confidence intervals [CIs]) for ever smoking (after adjusting for age, marital status, occupation, education, diastolic blood pressure, and triglyceride and cholesterol levels) for deaths resulting from all causes, all cancer, and coronary heart disease were, respectively, 2.42 (95% CI, 1.72-3.42), 2.50 (95% CI, 1.41-4.43), and 3.61 (95% CI, 1.35-9.67) in men and 2.32 (95% CI, 1.18-4.56), 1.98 (95% CI, 0.50-7.92), and 4.67 (95% CI, 0.78-27.8) in women.CONCLUSIONS: Previous prospective studies of smoking-related mortality in China tended to underestimate the risks, probably because of short durations of follow-up. We have demonstrated that smoking is a major cause of death in China, and the risks are similar to those seen in the United States and the United Kingdom. Thus, about half of the 300 million smokers in China will eventually die of smoking-related diseases if urgent tobacco-control measures are not instituted to prevent this growing epidemic.


Rick