Abstract
OBJECTIVE: To describe the prevalence and patterns of smoking among Canadian adults, the relation of smoking to other cardiovascular disease risk factors and the awareness of the causes of heart disease. DESIGN: Population-based cross-sectional surveys. SETTING: Nine Canadian provinces, from 1986 to 1990. PARTICIPANTS: A probability sample of 26,293 men and women aged 18 to 74 was selected from the health insurance registries in each province. Of these, 20,585 completed a questionnaire on smoking habits during a home interview. MAIN RESULTS: Approximately 29% of the Canadian population 18 years of age and over were regular cigarette smokers, and over 13% of regular smokers smoked more than 25 cigarettes per day. The proportion of women who had never smoked was higher (37%) than men (24%), except for young women aged 18 to 24. For all participants, there was a lower prevalence of high blood pressure and overweight among smokers than non-smokers. The prevalence of sedentary lifestyle, diabetes and elevated blood cholesterol was positively associated with smoking. The proportion of subjects who identified smoking as a cause of heart disease was higher among smokers, and over 90% believe that heart disease is preventable. CONCLUSION: Because smoking is positively associated with other cardiovascular risk factors, multifactorial and comprehensive approaches are needed in the implementation of cardiovascular disease prevention programs. Knowledge regarding the heart health hazards of smoking is high even among smokers. Motivational approaches that go beyond health risk messages are needed in cessation programs.
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- Arntzenius A. C., van Gent C. M., van der Voort H., Stegerhoek C. I., Styblo K. Reduced high-density lipoprotein in women aged 40-41 using oral contraceptives. Consultation Bureau Heart Project. Lancet. 1978 Jun 10;1(8076):1221–1223. doi: 10.1016/s0140-6736(78)92461-3. [DOI] [PubMed] [Google Scholar]
- Beard C. M., Kottke T. E., Annegers J. F., Ballard D. J. The Rochester Coronary Heart Disease Project: effect of cigarette smoking, hypertension, diabetes, and steroidal estrogen use on coronary heart disease among 40- to 59-year-old women, 1960 through 1982. Mayo Clin Proc. 1989 Dec;64(12):1471–1480. doi: 10.1016/s0025-6196(12)65702-4. [DOI] [PubMed] [Google Scholar]
- Collishaw N. E., Tostowaryk W., Wigle D. T. Mortality attributable to tobacco use in Canada. Can J Public Health. 1988 May-Jun;79(3):166–169. [PubMed] [Google Scholar]
- Craig W. Y., Palomaki G. E., Haddow J. E. Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. BMJ. 1989 Mar 25;298(6676):784–788. doi: 10.1136/bmj.298.6676.784. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Cuesta C., Sánchez-Muniz F. J., García-La Cuesta A., Garrido R., Castro A., San-Felix B., Domingo A. Effects of age and cigarette smoking on serum concentrations of lipids and apolipoproteins in a male military population. Atherosclerosis. 1989 Nov;80(1):33–39. doi: 10.1016/0021-9150(89)90065-8. [DOI] [PubMed] [Google Scholar]
- Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fielding J. E. Smoking: health effects and control (1). N Engl J Med. 1985 Aug 22;313(8):491–498. doi: 10.1056/NEJM198508223130807. [DOI] [PubMed] [Google Scholar]
- Ford E. S., DeStefano F. Risk factors for mortality from all causes and from coronary heart disease among persons with diabetes. Findings from the National Health and Nutrition Examination Survey I Epidemiologic Follow-up Study. Am J Epidemiol. 1991 Jun 15;133(12):1220–1230. doi: 10.1093/oxfordjournals.aje.a115834. [DOI] [PubMed] [Google Scholar]
- Gibbons L. W., Blair S. N., Cooper K. H., Smith M. Association between coronary heart disease risk factors and physical fitness in healthy adult women. Circulation. 1983 May;67(5):977–983. doi: 10.1161/01.cir.67.5.977. [DOI] [PubMed] [Google Scholar]
- Gordon T., Kannel W. B. Multiple risk functions for predicting coronary heart disease: the concept, accuracy, and application. Am Heart J. 1982 Jun;103(6):1031–1039. doi: 10.1016/0002-8703(82)90567-1. [DOI] [PubMed] [Google Scholar]
- Hammond E. C., Garfinkel L. Coronary heart disease, roke, and aortic aneurysm. Factors in the etiology. Arch Environ Health. 1969 Aug;19(2):167–182. [PubMed] [Google Scholar]
- Inman W. H. Oral contraceptives and fatal subarachnoid haemorrhage. Br Med J. 1979 Dec 8;2(6203):1468–1470. doi: 10.1136/bmj.2.6203.1468. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jensen G., Nyboe J., Appleyard M., Schnohr P. Risk factors for acute myocardial infarction in Copenhagen, II: Smoking, alcohol intake, physical activity, obesity, oral contraception, diabetes, lipids, and blood pressure. Eur Heart J. 1991 Mar;12(3):298–308. doi: 10.1093/oxfordjournals.eurheartj.a059894. [DOI] [PubMed] [Google Scholar]
- Kannel W. B., McGee D., Gordon T. A general cardiovascular risk profile: the Framingham Study. Am J Cardiol. 1976 Jul;38(1):46–51. doi: 10.1016/0002-9149(76)90061-8. [DOI] [PubMed] [Google Scholar]
- Kannel W. B. The clinical heterogeneity of hypertension. Am J Hypertens. 1991 Mar;4(3 Pt 1):283–287. doi: 10.1093/ajh/4.3.283. [DOI] [PubMed] [Google Scholar]
- Kannel W. B., Wilson P. W., Zhang T. J. The epidemiology of impaired glucose tolerance and hypertension. Am Heart J. 1991 Apr;121(4 Pt 2):1268–1273. doi: 10.1016/0002-8703(91)90432-h. [DOI] [PubMed] [Google Scholar]
- Keys A., Aravanis C., Blackburn H. W., Van Buchem F. S., Buzina R., Djordjević B. D., Dontas A. S., Fidanza F., Karvonen M. J., Kimura N. Epidemiological studies related to coronary heart disease: characteristics of men aged 40-59 in seven countries. Acta Med Scand Suppl. 1966;460:1–392. [PubMed] [Google Scholar]
- Krupski W. C. The peripheral vascular consequences of smoking. Ann Vasc Surg. 1991 May;5(3):291–304. doi: 10.1007/BF02329389. [DOI] [PubMed] [Google Scholar]
- Marti B., Tuomilehto J., Salomaa V., Kartovaara L., Korhonen H. J., Pietinen P. Body fat distribution in the Finnish population: environmental determinants and predictive power for cardiovascular risk factor levels. J Epidemiol Community Health. 1991 Jun;45(2):131–137. doi: 10.1136/jech.45.2.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mjøs O. D. Lipid effects of smoking. Am Heart J. 1988 Jan;115(1 Pt 2):272–275. doi: 10.1016/0002-8703(88)90649-7. [DOI] [PubMed] [Google Scholar]
- Powell K. E., Thompson P. D., Caspersen C. J., Kendrick J. S. Physical activity and the incidence of coronary heart disease. Annu Rev Public Health. 1987;8:253–287. doi: 10.1146/annurev.pu.08.050187.001345. [DOI] [PubMed] [Google Scholar]
- Reid D. D., Hamilton P. J., McCartney P., Rose G., Jarrett R. J., Keen H. Smoking and other risk factors for coronary heart-disease in British civil servants. Lancet. 1976 Nov 6;2(7993):979–984. doi: 10.1016/s0140-6736(76)90830-8. [DOI] [PubMed] [Google Scholar]
- Rosenberg L., Slone D., Shapiro S., Kaufman D., Stolley P. D., Miettinen O. S. Noncontraceptive estrogens and myocardial infarction in young women. JAMA. 1980 Jul 25;244(4):339–342. [PubMed] [Google Scholar]
- Shapiro S., Slone D., Rosenberg L., Kaufman D. W., Stolley P. D., Miettinen O. S. Oral-contraceptive use in relation to myocardial infarction. Lancet. 1979 Apr 7;1(8119):743–747. doi: 10.1016/s0140-6736(79)91205-4. [DOI] [PubMed] [Google Scholar]
- Stacy R. D., Loyd B. H. An investigation of beliefs about smoking among diabetes patients: information for improving cessation efforts. Patient Educ Couns. 1990 Apr;15(2):181–189. doi: 10.1016/0738-3991(90)90061-o. [DOI] [PubMed] [Google Scholar]
- Stellman S. D., Garfinkel L. Smoking habits and tar levels in a new American Cancer Society prospective study of 1.2 million men and women. J Natl Cancer Inst. 1986 Jun;76(6):1057–1063. [PubMed] [Google Scholar]
- Taylor C. B., Fortmann S. P., Flora J., Kayman S., Barrett D. C., Jatulis D., Farquhar J. W. Effect of long-term community health education on body mass index. The Stanford Five-City Project. Am J Epidemiol. 1991 Aug 1;134(3):235–249. doi: 10.1093/oxfordjournals.aje.a116077. [DOI] [PubMed] [Google Scholar]
- Wahl P., Walden C., Knopp R., Hoover J., Wallace R., Heiss G., Rifkind B. Effect of estrogen/progestin potency on lipid/lipoprotein cholesterol. N Engl J Med. 1983 Apr 14;308(15):862–867. doi: 10.1056/NEJM198304143081502. [DOI] [PubMed] [Google Scholar]
- Willett W. C., Green A., Stampfer M. J., Speizer F. E., Colditz G. A., Rosner B., Monson R. R., Stason W., Hennekens C. H. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Engl J Med. 1987 Nov 19;317(21):1303–1309. doi: 10.1056/NEJM198711193172102. [DOI] [PubMed] [Google Scholar]