Smoking may be associated with renal failure, intestinal ischemia, hypertensive heart disease, infections, and respiratory diseases other than chronic obstructive pulmonary disease (COPD), according to a report published February 12 online ahead of print in the New England Journal of Medicine.


Senior author Eric J. Jacobs, PhD, and colleagues analyzed data on nearly one million men and women, aged 55 years or older, who were enrolled in five major U.S. cohort studies. The authors found that current smokers had death rates that were nearly three times higher than in people who had never smoked, and that the majority of excess deaths in smokers were due to 21 diseases that are established by the U.S. Surgeon General as being caused by smoking.


However, they found that 17% of the excess deaths in smokers in these studies were caused by diseases that are not officially cited as caused by smoking. Smoking was associated with a risk of death that was two or more times higher in these conditions, which included renal failure, intestinal ischemia, hypertensive heart disease, infections, and respiratory diseases other than COPD.


Smoking was also associated with smaller increases in risk of death from other causes not formally established as caused by smoking, including breast cancer, prostate cancer, and cancers of unknown site.



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“These associations should be investigated further and, when appropriate, taken into account when the mortality burden of smoking is investigated,” stated Dr. Jacobs and colleagues.