Impact of smoking: all-cause and cardiovascular mortality in a cohort of 55-year-old Swedes and
Estonians
Sammanfattning
Aim: In the 1990s, several studies noted a large gap in life expectancy between Western and
Eastern European countries. It was speculated that this could be explained by environmental
pollution, socioeconomic factors, lifestyle and psychosocial stress. A weakness in addressing the
issue has been the lack of prospective studies with mortality as end point. Methods: We used the
national population registries (between 1996 and 1998) to screen a cohort of 269 55-year-old subjects
in Sweden and Estonia. We assessed conventional risk factors, lifestyle and socio-economic factors.
A 13-year follow-up regarding all-cause and cardiovascular mortality was done. Results: Smoking
and, to a lesser extent, plasma levels of interleukin-6 were significant predictors for CVD and non-
CVD mortality in men, but none of the other conventional risk factors reached statistical significance.
During the follow-up period, 22 of the 52 male smokers died compared to 8 of the 85 male non-
smokers (p<0.01). Ten of the smokers died of CVD compared to three of the non-smokers (p<0.002). In
total, only two women died. Conclusions: These data emphasize that smoking prevention is
extremely important in preventing premature death. Although smoking prevalence is diminishing, it is
still the most important risk factor to treat.