A Prospective Study of Tobacco Smoking and Mortality in Bangladesh

Fen Wu, Yu Chen, Faruque Parvez, Stephanie Segers, Maria Argos, Tariqul Islam, Alauddin Ahmed, Muhammad Rakibuz-Zaman, Rabiul Hasan, Golam Sarwar, Habibul Ahsan

Research output: Contribution to journalArticle

Abstract

Background: Limited data are available on smoking-related mortality in low-income countries, where both chronic disease burden and prevalence of smoking are increasing. Methods: Using data on 20, 033 individuals in the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh, we prospectively evaluated the association between tobacco smoking and all-cause, cancer, and cardiovascular disease mortality during ~7.6 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and their 95% confidence intervals (CIs) for deaths from all-cause, cancer, CVD, ischemic heart disease (IHD), and stroke, in relation to status, duration, and intensity of cigarette/bidi and hookah smoking. Results: Among men, cigarette/bidi smoking was positively associated with all-cause (HR 1.40, 95% CI 1.06 1.86) and cancer mortality (HR 2.91, 1.24 6.80), and there was a dose-response relationship between increasing intensity of cigarette/bidi consumption and increasing mortality. An elevated risk of death from ischemic heart disease (HR 1.87, 1.08 3.24) was associated with current cigarette/bidi smoking. Among women, the corresponding HRs were 1.65 (95% CI 1.16 2.36) for all-cause mortality and 2.69 (95% CI 1.20 6.01) for ischemic heart disease mortality. Similar associations were observed for hookah smoking. There was a trend towards reduced risk for the mortality outcomes with older age at onset of cigarette/bidi smoking and increasing years since quitting cigarette/bibi smoking among men. We estimated that cigarette/bidi smoking accounted for about 25.0% of deaths in men and 7.6% in women. Conclusions: Tobacco smoking was responsible for substantial proportion of premature deaths in the Bangladeshi population, especially among men. Stringent measures of tobacco control and cessation are needed to reduce tobacco-related deaths in Bangladesh.

Original languageEnglish (US)
Article numbere58516
JournalPLoS One
Volume8
Issue number3
DOIs
StatePublished - Mar 11 2013

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Bangladesh
smoking (habit)
Tobacco
prospective studies
Tobacco Products
Smoking
Hazards
Prospective Studies
Mortality
death
confidence interval
myocardial ischemia
cigarettes
neoplasms
Confidence Intervals
tobacco
Myocardial Ischemia
burden of disease
disease prevalence
Arsenic

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Wu, F., Chen, Y., Parvez, F., Segers, S., Argos, M., Islam, T., ... Ahsan, H. (2013). A Prospective Study of Tobacco Smoking and Mortality in Bangladesh. PLoS One, 8(3), [e58516]. https://doi.org/10.1371/journal.pone.0058516

A Prospective Study of Tobacco Smoking and Mortality in Bangladesh. / Wu, Fen; Chen, Yu; Parvez, Faruque; Segers, Stephanie; Argos, Maria; Islam, Tariqul; Ahmed, Alauddin; Rakibuz-Zaman, Muhammad; Hasan, Rabiul; Sarwar, Golam; Ahsan, Habibul.

In: PLoS One, Vol. 8, No. 3, e58516, 11.03.2013.

Research output: Contribution to journalArticle

Wu, F, Chen, Y, Parvez, F, Segers, S, Argos, M, Islam, T, Ahmed, A, Rakibuz-Zaman, M, Hasan, R, Sarwar, G & Ahsan, H 2013, 'A Prospective Study of Tobacco Smoking and Mortality in Bangladesh', PLoS One, vol. 8, no. 3, e58516. https://doi.org/10.1371/journal.pone.0058516
Wu, Fen ; Chen, Yu ; Parvez, Faruque ; Segers, Stephanie ; Argos, Maria ; Islam, Tariqul ; Ahmed, Alauddin ; Rakibuz-Zaman, Muhammad ; Hasan, Rabiul ; Sarwar, Golam ; Ahsan, Habibul. / A Prospective Study of Tobacco Smoking and Mortality in Bangladesh. In: PLoS One. 2013 ; Vol. 8, No. 3.
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AU - Wu, Fen

AU - Chen, Yu

AU - Parvez, Faruque

AU - Segers, Stephanie

AU - Argos, Maria

AU - Islam, Tariqul

AU - Ahmed, Alauddin

AU - Rakibuz-Zaman, Muhammad

AU - Hasan, Rabiul

AU - Sarwar, Golam

AU - Ahsan, Habibul

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