Smoking-attributable mortality in American Indians: findings from the Strong Heart Study

Mingzhi Zhang, Qiang An, Fawn Yeh, Ying Zhang, Barbara V Howard, Elisa T Lee, Jinying Zhao, Mingzhi Zhang, Qiang An, Fawn Yeh, Ying Zhang, Barbara V Howard, Elisa T Lee, Jinying Zhao

Abstract

Cigarette smoking is the leading preventable cause of death worldwide. American Indians have the highest proportion of smoking in the United States. However, few studies have examined the impact of cigarette smoking on disease mortality in this ethnically important but traditionally understudied minority population. Here we estimated the association of cigarette smoking with cardiovascular disease (CVD), cancer and all-cause mortality in American Indians participating in the Strong Heart Study, a large community-based prospective cohort study comprising of 4549 American Indians (aged 45-74 years) followed for about 20 years (1989-2008). Hazard ratio and population attributable risk (PAR) associated with cigarette smoking were estimated by Cox proportional hazard model, adjusting for sex, study site, age, educational level, alcohol consumption, physical activity, BMI, lipids, renal function, hypertension or diabetes status at baseline, and interaction between current smoker and study site. We found that current smoking was significantly associated with cancer mortality (HR 5.0, [1.9-13.4]) in men, (HR 3.9 [1.6-9.7] in women) and all-cause mortality (HR 1.8, [1.2-2.6] in men, HR 1.6, [1.1-2.4] in women). PAR for cancer and all-cause mortality in men were 41.0 and 18.4 %, respectively, whereas the corresponding numbers in women were 24.9 and 10.9 %, respectively. Current smoking also significantly increases the risk of CVD deaths in women (HR 2.2 [1.1, 4.4]), but not men (HR 1.2 [0.6-2.4]). PAR for CVD mortality in women was 14.9 %. In summary, current smoking significantly increases the risk of CVD (in women), cancer and all-cause mortality in American Indians, independent of known risk factors. Culturally specific smoking cessation programs are urgently needed to reduce smoking-related premature deaths.

Conflict of interest statement

Competing interests

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References

    1. Danaei G, Ding EL, Mozaffarian D, et al. The preventable causes of death in the United States: comparative risk assessment of dietary, lifestyle, and metabolic risk factors. PLoS Med. 2009;6(4):e1000058.
    1. U.S. Department of Health and Human Services. The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General. Atlanta (GA): 2014.
    1. Thun MJ, Carter BD, Feskanich D, et al. 50-year trends in smoking-related mortality in the United States. N Engl J Med. 2013;368(4):351–64.
    1. Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med. 2013;368(4):341–50.
    1. Agaku IT, King BA, Dube SR, Centers for Disease C, Prevention Current cigarette smoking among adults – United States, 2005–2012. MMWR. 2014;63(2):29–34.
    1. Eichner JE, Wang W, Zhang Y, Lee ET, Welty TK. Tobacco use and cardiovascular disease among American Indians: the strong heart study. Int J Environ Res Public Health. 2010;7(10):3816–30.
    1. Lee ET, Welty TK, Fabsitz R, et al. The Strong Heart Study. A study of cardiovascular disease in American Indians: design and methods. American journal of epidemiology. 1990;132(6):1141–55.
    1. Howard BV, Lee ET, Cowan LD, et al. Coronary heart disease prevalence and its relation to risk factors in American Indians. The Strong Heart Study. American journal of epidemiology. 1995;142(3):254–68.
    1. Lee ET, Howard BV, Savage PJ, et al. Diabetes and impaired glucose tolerance in three American Indian populations aged 45–74 years. The Strong Heart Study. Diabetes Care. 1995;18(5):599–610.
    1. Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate. Annals of internal medicine. 2009;150(9):604–12.
    1. Howard BV, Welty TK, Fabsitz RR, et al. Risk factors for coronary heart disease in diabetic and nondiabetic Native Americans. The Strong Heart Study. Diabetes. 1992;41(Suppl 2):4–11.
    1. Lu W, Jablonski KA, Resnick HE, et al. Alcohol intake and glycemia in American Indians: the strong heart study. Metabolism. 2003;52(2):129–35.
    1. Fretts AM, Howard BV, Kriska AM, et al. Physical activity and incident diabetes in American Indians: the Strong Heart Study. American journal of epidemiology. 2009;170(5):632–9.
    1. Kriska AM, Knowler WC, LaPorte RE, et al. Development of questionnaire to examine relationship of physical activity and diabetes in Pima Indians. Diabetes Care. 1990;13(4):401–11.
    1. Report of the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 1997;20(7):1183–97.
    1. Lee ET, Cowan LD, Welty TK, et al. All-cause mortality and cardiovascular disease mortality in three American Indian populations, aged 45–74 years, 1984–1988. The Strong Heart Study. American journal of epidemiology. 1998;147(11):995–1008.
    1. Klein RJ, Schoenborn CA. Age adjustment using the 2000 projected U.S. population. Healthy People 2010 Stat Notes. 2001;(20):1–10.
    1. Hoyert DL, Anderson RN. Age-adjusted death rates: trend data based on the year 2000 standard population. Natl Vital Stat Rep. 2001;49(9):1–6.
    1. Curtin LR, Klein RJ. Direct standardization (age-adjusted death rates) Healthy People 2000 Stat Notes. 1995;(6):1–10.
    1. Rockhill B, Newman B, Weinberg C. Use and misuse of population attributable fractions. American journal of public health. 1998;88(1):15–9.
    1. Stover DE. Women, smoking, and lung cancer. Chest. 1998;113(1):1–2.
    1. Huxley RR, Woodward M. Full hazards of smoking and benefits of stopping for women. Lancet. 2013;381(9861):96–8.
    1. Cook MB, McGlynn KA, Devesa SS, Freedman ND, Anderson WF. Sex disparities in cancer mortality and survival. Cancer Epidemiol Biomarkers Prev. 2011;20(8):1629–37.
    1. Cook MB, Dawsey SM, Freedman ND, et al. Sex disparities in cancer incidence by period and age. Cancer Epidemiol Biomarkers Prev. 2009;18(4):1174–82.
    1. Zang EA, Wynder EL. Differences in lung cancer risk between men and women: examination of the evidence. J Natl Cancer Inst. 1996;88(3–4):183–92.
    1. Nez Henderson P, Jacobsen C, Beals J, Team A-S. Correlates of cigarette smoking among selected Southwest and Northern plains tribal groups: the AI-SUPERPFP Study. American journal of public health. 2005;95(5):867–72.
    1. Rith-Najarian SJ, Gohdes DM, Shields R, et al. Regional variation in cardiovascular disease risk factors among American Indians and Alaska Natives with diabetes. Diabetes Care. 2002;25(2):279–83.
    1. Welty TK, Lee ET, Yeh J, et al. Cardiovascular disease risk factors among American Indians. The Strong Heart Study. American journal of epidemiology. 1995;142(3):269–87.
    1. Wakefield M, Flay B, Nichter M, Giovino G. Role of the media in influencing trajectories of youth smoking. Addiction. 2003;98(Suppl 1):79–103.
    1. Pego Christina M, H RF, Solomon Glenn W, Chisholm Robert M, Ivey Suzanne E. Tobacco, Culture, and Health among American Indians: A Historical Review. American Indian Culture and Research Journal. 1995;19(2):143–64.
    1. Godlaski TM. Holy smoke: tobacco use among native american tribes in North America. Subst Use Misuse. 2013;48(1–2):1–8.
    1. Fu SS, Rhodes KL, Robert C, Widome R, Forster JL, Joseph AM. Designing and evaluating culturally specific smoking cessation interventions for American Indian communities. Nicotine Tob Res. 2014;16(1):42–9.
    1. Choi WS, Faseru B, Beebe LA, et al. Culturally-tailored smoking cessation for American Indians: study protocol for a randomized controlled trial. Trials. 2011;12:126.
    1. Rosenberg L, Kaufman DW, Helmrich SP, Shapiro S. The risk of myocardial infarction after quitting smoking in men under 55 years of age. N Engl J Med. 1985;313(24):1511–4.
    1. Rosenberg L, Palmer JR, Shapiro S. Decline in the risk of myocardial infarction among women who stop smoking. N Engl J Med. 1990;322(4):213–7.
    1. Suskin N, Sheth T, Negassa A, Yusuf S. Relationship of current and past smoking to mortality and morbidity in patients with left ventricular dysfunction. J Am Coll Cardiol. 2001;37(6):1677–82.
    1. Tonelli M, Wiebe N, Culleton B, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006;17(7):2034–47.
    1. Narva AS. The spectrum of kidney disease in American Indians. Kidney Int Suppl. 2003;(83):S3–7.
    1. Gibson CM, Pinto DS, Murphy SA, et al. Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality. J Am Coll Cardiol. 2003;42(9):1535–43.

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