Tobacco Smoking and Mortality in Asia. A Pooled Meta-analysis
JAMA Netw Open. 2019;2(3):e191474. doi:10.1001/jamanetworkopen.2019.1474
1,000,000 participants in 20 cohort studies in this Asian meta-analysis
- Low Vitamin D is worse for your health than smoking
- Each ng extra vitamin D associated with better breathing (and 2X better for smokers) – March 2018
- If smoke, try Vitamin D - reduce damage or help quit - 2012
- Both parents smoke – child’s vitamin D level was 30 percent lower and worse asthma – May 2018
- Child exposed to smoke is 1.5 X more likely to have low vitamin D – Oct 2018
Smoking reduces vitamin D - many studies contains the following
Two pathways are often proposed for how smoking decreases vitamin D:
1) Smoking decreases Calcium. and Vitamin D is used up in replacing the Calcium
2) Smoking injures the body, and vitamin D is used up in repairing the body
It appears that taking Vitamin D while smoking will:
1) Decrease the incidence of the many health problems associated with smoking - even lung cancer
2) Decrease the desire to smoke (perhaps take fewer smoking breaks?)
3) Increase breathing capacity
Opinion: If unable to stop smoking,
or are a previous smoker,
or are getting 2nd hand smoke,
increase Vitamin D and perhaps Omega-3 (which decreases depression, inflammation)
non-daily Vit D appears to be best
Vitamin D should also help people quit smoking See bottom of page Smoking reduces vitamin D
1) Reduces weight gain associated with quitting smoking
2) Reduces depression associated with quitting smoking
Lung Cancer reduced by Vitamin D
- Lung Cancer risk decreased 2.4 percent with every 100 IU Vitamin D extra intake – meta-analysis Sept 2018
- Lung Cancer death 60 percent less likely if high level of vitamin D – 2 meta-analysis 2017
- Lung Cancer risk decreases 5 percent for every 2.5 nanogram increase in Vitamin D – meta-analysis Sept 2015
- Lung cancer and inhaled emulsions (wonder about inhaled Vitamin D) – 2018
- Smoking does not decrease Vitamin D taken monthly – RCT July 2020
- Perhaps taking vitamin D monthly is better than daily if you smoke. Do not know why
I, the founder of VitaminDWiki, have always believed that being healthy is worth the effort - both in short and long term. Health is an addiction for me.
- I sleep longer and am not as alert after just 3 days without exercise
- At age 65 I started to get aches and pains after a week without Vitamin D, etc. (normally totally pain-free)
- Many people who start Vitamin D with a loading dose feel the benefits within a week, and become addicted
- There have been
43 loading dose trials, virtually all very successful
- A loading dose costs about $2, no prescription needed
Addictions are hard to break.
- People are also have become addicted to sugar (thanks to Big Tobacco)
- Wonder if there is some way to get people addicted to being healthy/keeping their vitamin D levels high?
- Perhaps a loading dose of vitamin D, so benefits can be quickly felt
Download the PDF from VitaminDWiki
Apparently 60% of Chinese males smoke
Far fewer Chinese women: had been 20%, but now <4%
Again it appears that women are more concerned about health than men
4X more likely to die of lung Cancer
- Question How are secular trends of tobacco smoking associated with mortality across countries or regions by birth cohorts in Asia?
- Findings This pooled meta-analysis of 1 002 258 participants in 20 prospective cohort studies shows that smoking-attributable mortality continued to increase among Asian men in successive birth cohorts, with the tobacco smoking epidemic worsening in the past few decades.
- Meaning Tobacco smoking will remain a significant public health problem in most Asian countries, stressing the need to implement and enhance comprehensive tobacco-control programs in Asia.
Importance Understanding birth cohort–specific tobacco smoking patterns and their association with total and cause-specific mortality is important for projecting future deaths due to tobacco smoking across Asian populations.
Objectives To assess secular trends of tobacco smoking by countries or regions and birth cohorts and evaluate the consequent mortality in Asian populations.
Design, Setting, and Participants This pooled meta-analysis was based on individual participant data from 20 prospective cohort studies participating in the Asia Cohort Consortium. Between September 1, 2017, and March 31, 2018, a total of 1 002 258 Asian individuals 35 years or older were analyzed using Cox proportional hazards regression analysis and random-effects meta-analysis. The pooled results were presented for mainland China; Japan; Korea, Singapore, and Taiwan; and India.
Exposures Tobacco use status, age at starting smoking, number of cigarettes smoked per day, and age at quitting smoking.
Main Outcomes and Measures Country or region and birth cohort–specific mortality and the population attributable risk for deaths from all causes and from lung cancer.
Results Of 1 002 258 participants (51.1% women and 48.9% men; mean [SD] age at baseline, 54.6 [10.4] years), 144 366 deaths (9158 deaths from lung cancer) were ascertained during a mean (SD) follow-up of 11.7 (5.3) years. Smoking prevalence for men steadily increased in China and India, whereas it plateaued in Japan and Korea, Singapore, and Taiwan. Among Asian male smokers, the mean age at starting smoking decreased in successive birth cohorts, while the mean number of cigarettes smoked per day increased. These changes were associated with an increasing relative risk of death in association with current smoking in successive birth cohorts of pre-1920, 1920s, and 1930 or later, with hazard ratios for all-cause mortality of 1.26 (95% CI, 1.17-1.37) for the pre-1920 birth cohort, 1.47 (95% CI, 1.35-1.61) for the 1920s birth cohort, and 1.70 (95% CI, 1.57-1.84) for the cohort born in 1930 or later. The hazard ratios for lung cancer mortality were 3.38 (95% CI, 2.25-5.07) for the pre-1920 birth cohort, 4.74 (95% CI, 3.56-6.32) for the 1920s birth cohort, and 4.80 (95% CI, 3.71-6.19) for the cohort born in 1930 or later. Tobacco smoking accounted for 12.5% (95% CI, 8.4%-16.3%) of all-cause mortality in the pre-1920 birth cohort, 21.1% (95% CI, 17.3%-24.9%) of all-cause mortality in the 1920s birth cohort, and 29.3% (95% CI, 26.0%-32.3%) of all-cause mortality for the cohort born in 1930 or later. Tobacco smoking among men accounted for 56.6% (95% CI, 44.7%-66.3%) of lung cancer mortality in the pre-1920 birth cohort, 66.6% (95% CI, 58.3%-73.5%) of lung cancer mortality in the 1920s birth cohort, and 68.4% (95% CI, 61.3%-74.4%) of lung cancer mortality for the cohort born in 1930 or later. For women, tobacco smoking patterns and lung cancer mortality varied substantially by countries and regions.
Conclusions and Relevance In this study, mortality associated with tobacco smoking continued to increase among Asian men in recent birth cohorts, indicating that tobacco smoking will remain a major public health problem in most Asian countries in the coming decades. Implementing comprehensive tobacco-control programs is warranted to end the tobacco epidemic.Asian men often smoke then die of lung cancer (if you must smoke, take Vitamin D) – meta-analysis March 2019
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