Smoking and cancer, cardiovascular and total mortality among older adults: The Finrisk Study

Little information is available about the deleterious effect of smoking in older adults The objective of this study was to assess the relationship of smoking habits with cancer, CVD and all-cause mortality in late middle-age (45-64 years) and older (65-74) people. This cohort study of 6516 men and 6514 women studied the relationship of smoking habits with cancer, cardiovascular disease (CVD) and all-cause mortality among middle-aged and older Finnish men and women during 1997-2013. The study cohort was followed up until the end of 2013 (median follow-up time was 11.8 years). Mortality data were obtained from the National Causes of Death Register and data on incident stroke events from the National Hospital Discharge Register. Adjusted Hazard ratios (HR) for total mortality were 2.61 (95% Confidence interval 2.15-3.18) among 45-64 years-old men and 2.59 (2.03-3.29) in 65-74 years-old men. The corresponding HRs for women 45-64 years-of-age were 3.21 (2.47-4.19) and 3.12 (2.09-4.68) for those 65-74 years-old, respectively. Adjusted HRs for CVD mortality in the 45-64 years-old and 65-74 years-old groups were 2.67 (1.92-2.67) and 1.95 (1.33-2.86) in men, and 4.28 (2.29-7.99) and 2.67 (1.28-5.58) in women, respectively. Among men, the risk difference between never and current smokers was 108/100.000 in the age-group 45-64 years, and 324/100.000 in the age group 65-74 years. Among women the differences were 52/100.000 and 196/100.000, respectively. In conclusion, absolute risk difference between never and current smokers are larger among the older age group. Smoking cessation counseling should routinely target also older adults in primary health-care.