有力证据!就算每天只抽1根烟,也大大增加心脏病和中风风险
2018/01/29
众所周知,吸烟有害健康!事实上,这绝不只是说说而已——1月24日,最新发表在The BMJ杂志上的一项研究证实,每天只抽1根烟导致的患冠心病和中风的风险比预期要高得多!科学家们建议:为了显著降低患心脏病和中风的风险,吸烟者应该完全停止吸烟,而不是减少吸烟量。


图片来源:网络

数据显示,目前全球范围内共有约9亿人吸烟。心血管疾病是吸烟最大的死亡风险,导致了约48%与吸烟有关的过早死亡。

此前,有个别研究称,每天只抽1-5根烟也与患心脏病风险增加有关,并且这种增加高于预期水平。为了进一步调查这一问题,英国伦敦大学学院的Allan Hackshaw教授领导的研究小组分析了来自21个国家和地区的141项研究(追踪了560万名冠心病患者和730万名中风患者),评估了每天抽1根、5根或20根烟的相对风险。


图片来源:The BMJ(DOI: https://doi.org/10.1136/bmj.j5855)

结果显示,每天抽1根烟的男性患心脏病的风险高出46%,中风的风险增加41%(远高于预期的5%);对女性来说,每天抽1根烟的人患心脏病的风险高出31%,中风的风险增加34%。

Hackshaw教授说:“我们的研究表明,大部分冠心病和中风的风险来自每天只抽几根烟。这可能会让很多人感到惊讶,但也有一些生物学机制能够帮助解释,为什么低水平的吸烟会带来如此意想不到的高风险。”


图片来源:BBC

在BBC关于该研究的报道中,英国公共卫生署的烟草主管Martin Dockrell表示:“这项研究再次向我们证实,将吸烟量减少至每天1根依然会带来患心脏病和中风的严重风险。”

总结来说,科学家们认为,这一发现对很多吸烟者以及“相信只抽几支烟几乎没有害处的人”具有重要影响。尽管存在一些局限性,但这篇论文是一项很有价值的参考,可为戒烟者提供一个强有力的健康激励,让他们完全停止吸烟。正如他们在结论中写道的那样,对于心血管疾病,没有所谓安全的吸烟水平。

参考资料:

Just one cigarette a day carries greater risk of heart disease and stroke than expected, warn expert

Just one cigarette a day seriously elevates cardiovascular risk

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  • Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports

    Objective To use the relation between cigarette consumption and cardiovascular disease to quantify the risk of coronary heart disease and stroke for light smoking (one to five cigarettes/day). Design Systematic review and meta-analysis. Data sources Medline 1946 to May 2015, with manual searches of references. Eligibility criteria for selecting studies Prospective cohort studies with at least 50 events, reporting hazard ratios or relative risks (both hereafter referred to as relative risk) compared with never smokers or age specific incidence in relation to risk of coronary heart disease or stroke. Data extraction/synthesis MOOSE guidelines were followed. For each study, the relative risk was estimated for smoking one, five, or 20 cigarettes per day by using regression modelling between risk and cigarette consumption. Relative risks were adjusted for at least age and often additional confounders. The main measure was the excess relative risk for smoking one cigarette per day (RR1_per_day−1) expressed as a proportion of that for smoking 20 cigarettes per day (RR20_per_day−1), expected to be about 5% assuming a linear relation between risk and consumption (as seen with lung cancer). The relative risks for one, five, and 20 cigarettes per day were also pooled across all studies in a random effects meta-analysis. Separate analyses were done for each combination of sex and disorder. Results The meta-analysis included 55 publications containing 141 cohort studies. Among men, the pooled relative risk for coronary heart disease was 1.48 for smoking one cigarette per day and 2.04 for 20 cigarettes per day, using all studies, but 1.74 and 2.27 among studies in which the relative risk had been adjusted for multiple confounders. Among women, the pooled relative risks were 1.57 and 2.84 for one and 20 cigarettes per day (or 2.19 and 3.95 using relative risks adjusted for multiple factors). Men who smoked one cigarette per day had 46% of the excess relative risk for smoking 20 cigarettes per day (53% using relative risks adjusted for multiple factors), and women had 31% of the excess risk (38% using relative risks adjusted for multiple factors). For stroke, the pooled relative risks for men were 1.25 and 1.64 for smoking one or 20 cigarettes per day (1.30 and 1.56 using relative risks adjusted for multiple factors). In women, the pooled relative risks were 1.31 and 2.16 for smoking one or 20 cigarettes per day (1.46 and 2.42 using relative risks adjusted for multiple factors). The excess risk for stroke associated with one cigarette per day (in relation to 20 cigarettes per day) was 41% for men and 34% for women (or 64% and 36% using relative risks adjusted for multiple factors). Relative risks were generally higher among women than men. Conclusions Smoking only about one cigarette per day carries a risk of developing coronary heart disease and stroke much greater than expected: around half that for people who smoke 20 per day. No safe level of smoking exists for cardiovascular disease. Smokers should aim to quit instead of cutting down to significantly reduce their risk of these two common major disorders.

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