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. 1986 Mar-Apr;101(2):163–173.

The contribution of smoking to sex differences in mortality.

I Waldron
PMCID: PMC1477787  PMID: 3083471

Abstract

The contribution of smoking to sex differences in mortality is estimated on the basis of data from 12 studies of the mortality of nonsmoking men and women, together with mortality data for comparable general population samples. Most of the data are for samples drawn from the U.S. population from the late 1950s to 1980. The findings from different studies are generally consistent, once methodological factors are taken into account. The findings indicate that, for total mortality, the proportion of sex differences attributable to smoking decreases from about two-thirds at age 40 to about one-quarter at age 80. Over the adult age span, it appears that about half of the sex difference in total mortality is attributable to smoking. Findings for ischemic heart disease mortality show a similar pattern. For lung cancer, it appears that about 90 percent of the sex difference in mortality is attributable to smoking. The estimated contributions of smoking include both the effects of sex differences in smoking habits and the effects of sex differences in the increase in mortality caused by smoking. The quantitative results should be interpreted with caution, since several lines of argument suggest that multivariate analyses controlling for other relevant factors would produce lower estimates of the contribution of smoking to sex differences in mortality. Despite this limitation, the findings analyzed in this review, together with additional evidence from related research, strongly support the conclusion that cigarette smoking makes a major contribution to men's higher mortality, but other factors also play an important role.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Berkel J., de Waard F. Mortality pattern and life expectancy of Seventh-Day Adventists in the Netherlands. Int J Epidemiol. 1983 Dec;12(4):455–459. doi: 10.1093/ije/12.4.455. [DOI] [PubMed] [Google Scholar]
  2. Breslow L., Enstrom J. E. Persistence of health habits and their relationship to mortality. Prev Med. 1980 Jul;9(4):469–483. doi: 10.1016/0091-7435(80)90042-0. [DOI] [PubMed] [Google Scholar]
  3. Casey A. E., Casey J. G. Long-lived male population with high cholesterol intake, Slieve Lougher, Ireland. Ala J Med Sci. 1970 Jan;7(1):21–26. [PubMed] [Google Scholar]
  4. Condran G. A., Crimmins E. A description and evaluation of mortality data in the federal census: 1850-1900. Hist Methods. 1979;12(1):1–23. [PubMed] [Google Scholar]
  5. Enstrom J. E., Godley F. H. Cancer mortality among a representative sample of nonsmokers in the United States during 1966--68. J Natl Cancer Inst. 1980 Nov;65(5):1175–1183. [PubMed] [Google Scholar]
  6. Enstrom J. E. Smoking and longevity studies. Science. 1984 Aug 31;225(4665):878–878. doi: 10.1126/science.6474159. [DOI] [PubMed] [Google Scholar]
  7. Feinleib M., Luoto J. Longevity of nonsmoking men and women. Public Health Rep. 1984 May-Jun;99(3):223–223. [PMC free article] [PubMed] [Google Scholar]
  8. Friedman G. D., Dales L. G., Ury H. K. Mortality in middle-aged smokers and nonsmokers. N Engl J Med. 1979 Feb 1;300(5):213–217. doi: 10.1056/NEJM197902013000501. [DOI] [PubMed] [Google Scholar]
  9. Fønnebø V. The Tromsø Heart Study: coronary risk factors in Seventh-Day Adventists. Am J Epidemiol. 1985 Nov;122(5):789–793. doi: 10.1093/oxfordjournals.aje.a114162. [DOI] [PubMed] [Google Scholar]
  10. Gupta P. C., Bhonsle R. B., Mehta F. S., Pindborg J. J. Mortality experience in relation to tobacco chewing and smoking habits from a 10-year follow-up study in Ernakulam District, Kerala. Int J Epidemiol. 1984 Jun;13(2):184–187. doi: 10.1093/ije/13.2.184. [DOI] [PubMed] [Google Scholar]
  11. HAENSZEL W., LOVELAND D. B., SIRKEN M. G. Lung-cancer mortality as related to residence and smoking histories. I. White males. J Natl Cancer Inst. 1962 Apr;28:947–1001. [PubMed] [Google Scholar]
  12. Hamman R. F., Barancik J. I., Lilienfeld A. M. Patterns of mortality in the the Old Order Amish. I. Background and major causes of death. Am J Epidemiol. 1981 Dec;114(6):845–861. doi: 10.1093/oxfordjournals.aje.a113255. [DOI] [PubMed] [Google Scholar]
  13. Hammond E. C., Seidman H. Smoking and cancer in the United States. Prev Med. 1980 Mar;9(2):169–174. doi: 10.1016/0091-7435(80)90071-7. [DOI] [PubMed] [Google Scholar]
  14. Hammond E. C. Smoking in relation to the death rates of one million men and women. Natl Cancer Inst Monogr. 1966 Jan;19:127–204. [PubMed] [Google Scholar]
  15. Holden C. Can smoking explain ultimate gender gap? Science. 1983 Sep 9;221(4615):1034–1034. doi: 10.1126/science.6879202. [DOI] [PubMed] [Google Scholar]
  16. Lemon F. R., Kuzma J. W. A biologic cost of smoking. Decreased life expectancy. Arch Environ Health. 1969 Jun;18(6):950–955. doi: 10.1080/00039896.1969.10665519. [DOI] [PubMed] [Google Scholar]
  17. Miller G. H., Gerstein D. R. The life expectancy of nonsmoking men and women. Public Health Rep. 1983 Jul-Aug;98(4):343–349. [PMC free article] [PubMed] [Google Scholar]
  18. Miller G. H. Male-female longevity comparisons among the Amish. J Indiana State Med Assoc. 1980 Jul;73(7):471–473. [PubMed] [Google Scholar]
  19. Morgan K. Mortality changes in the Hutterite Brethren of Alberta and Saskatchewan, Canada. Hum Biol. 1983 Feb;55(1):89–99. [PubMed] [Google Scholar]
  20. Mulcahy R., McGilvray J. W., Hickey N. Cigarette smoking related to geographic variations in coronary heart disease mortality and to expectation of life in the two sexes. Am J Public Health Nations Health. 1970 Aug;60(8):1515–1521. doi: 10.2105/ajph.60.8.1515. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mushinski M. H., Stellman S. D. Impact of new smoking trends on women's occupational health. Prev Med. 1978 Sep;7(3):349–365. doi: 10.1016/0091-7435(78)90280-3. [DOI] [PubMed] [Google Scholar]
  22. Phillips R. L., Kuzma J. W., Beeson W. L., Lotz T. Influence of selection versus lifestyle on risk of fatal cancer and cardiovascular disease among Seventh-day Adventists. Am J Epidemiol. 1980 Aug;112(2):296–314. doi: 10.1093/oxfordjournals.aje.a112996. [DOI] [PubMed] [Google Scholar]
  23. Rogot E., Feinleib M., Lambert P. M., Zeiner-Henriksen T. The British-Norwegian migrant study: 5-year mortality differentials due to cigarette smoking. Public Health Rep. 1985 May-Jun;100(3):301–307. [PMC free article] [PubMed] [Google Scholar]
  24. Waldron I. Sex differences in human mortality: the role of genetic factors. Soc Sci Med. 1983;17(6):321–333. doi: 10.1016/0277-9536(83)90234-4. [DOI] [PubMed] [Google Scholar]
  25. Williams R. R., Horm J. W. Association of cancer sites with tobacco and alcohol consumption and socioeconomic status of patients: interview study from the Third National Cancer Survey. J Natl Cancer Inst. 1977 Mar;58(3):525–547. doi: 10.1093/jnci/58.3.525. [DOI] [PubMed] [Google Scholar]
  26. Wingard D. L., Suarez L., Barrett-Connor E. The sex differential in mortality from all causes and ischemic heart disease. Am J Epidemiol. 1983 Feb;117(2):165–172. doi: 10.1093/oxfordjournals.aje.a113527. [DOI] [PubMed] [Google Scholar]

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