TOO LATE TO QUIT? EFFECT OF SMOKING AND SMOKING CESSATION ON MORBIDTY AND MORTALITY AMONG THE ELDERLY IN LONGITUDINAL STIDY

悔之已晚？吸菸與戒菸對老人罹病與死亡的影響：長期追蹤研究

徐慧娟(Hui-Chuan Hsu) ； 蒲若芳(Raoh-Fang Pwu)

《The Kaohsiung Journal of Medical Sciences》 20卷10期 (2004/10) Pp. 484-491

摘要

本研究目的在於探討吸菸狀況對老人罹病與死亡的影響，以及戒菸是否可降低老人罹病的危險性。資料來源來自國民健康局人口調查中心執行之「老人保健與生活長期追蹤調查」資料，該調查為面對面訪問，並為具台灣60歲以上老人代表性之隨機樣本。起始年1989年樣本數為4,049人，並於1993年與1996年長期追蹤。吸菸相關變項包括目前吸菸情形，吸菸史、每日吸菸量，以及戒菸年數。在控制人口、身體功能、其他罹病情形下，以Cox迴歸模式分析吸菸與戒菸對老人罹病或死亡的相對危險性。研究結果顯示，在追蹤起始年有50.2%的老人樣本沒有吸菸、15.2%已戒菸，而34.6%仍在吸菸。吸菸者自 1989一1996 年閒有較高危險罹患下呼吸道疾病，在1989－1993年問也有較高危險罹患中風。吸菸暴露量或吸菸年數的劑量反應效果對罹病或死亡並不顯著。欲確知戒菸是否為老年健康的保護因素，應從中年人追蹤到老年進一步研究。老年人的健康促進策略應從有效戒菸著手，並鼓勵及早戒菸並持續到老年。

關鍵字

吸菸 ； 戒菸 ； 長期追蹤研究 ； 老年人 ； 相對危險性 ； 成功老化

並列摘要

This prospective study of the elderly population estimated the risks of smoking for morbidity and mortality and identified whether cessation of smoking reduced the risk of disease. Data came from face-to-face interviews that used a population-based probability sample of those aged 60 years or over in Taiwan, provided by the Population and Health Research Center, Bureau of Health Promotion. In total, 4,049 subjects were included at the baseline year of 1989 and followed up in 1993 and 1996. Smoking-related variables included current smoking status, smoking history, daily consumption, and years since the cessation of smoking. Cox regression models were used to analyze the relative risks for morbidity and mortality, controlling for demographics, physical function, and comorbidities. The sample was made up of 50.2% nonsmokers, 15.2% ex-smokers, and 34.6% current smokers in the baseline year. Current smokers were more likely to have lower respiratory tract diseases throughout the study. Current smokers had a higher risk of stroke from 1989 to 1993. No dose-response relationship for smoking exposure or impact of years since smoking cessation was found. Whether cessation of smoking is protective should be investigated for middle-aged adults followed to old age. An effective strategy for smoking cessation in the elderly is suggested, and people should be encouraged to quit smoking at any time.

並列關鍵字

smoking ； smoking cessation ； longitudinal studies ； elderly ； relative risk ； successful aging