ArticlePloS one2020
Female vulnerability to the effects of smoking on health outcomes in older people.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it, 38 citations in OpenAlex.
- Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe.BMC public health · 2025Pooled it
- How education gets under the skin: Pathways linking educational advantage to slower biological aging.Social science & medicine (1982) · 2026Article
- Article
- Gender-specific sociodemographic and lifestyle factors associated with frailty status among Korean older adults.PloS one · 2026Article
- Trends in respiratory disease mortality in the United States, 1999-2024.Frontiers in medicine · 2026Article
- Sex, hormones, and lung health.Physiological reviews · 2026Review
- Behavioral and psychosocial predictors of e-cigarette use in rural Thailand: A cross-sectional propensity score-matched study.Tobacco induced diseases · 2026Article
- Gene expression composite scores of cellular senescence predict aging health outcomes in the Health and Retirement Study.Nature communications · 2025Article
- Does the southern health disadvantage extend to accelerated biological aging: evidence from the health and retirement study.The journals of gerontology. Series B, Psychological sciences and social sciences · 2025Article
- A gender perspective of smoking cessation's health and economic value in Jordanian women: using cost effectiveness model.Cost effectiveness and resource allocation : C/E · 2025Article
- Sex-based differences in histologic lung cancer incidence trends in the United States, 2005-2019.International journal of cancer · 2025Article
- Gender disparities in delayed angina diagnosis: insights from 2001-2020 NHANES data.BMC public health · 2025Article
- Influential Attributes on Medical Expense for Korean Older Adults Based on Mental Accounting: Panel Data Analysis Using Korean Longitudinal Study of Aging Data.Healthcare (Basel, Switzerland) · 2025Article
- Lifestyle Changes and Remission in Patients With New-Onset Type 2 Diabetes: A Nationwide Cohort Study.Journal of Korean medical science · 2025Article
- Quality of Oral Anticoagulation Control with Warfarin According to Sex: A Cross-Sectional Study.International journal of environmental research and public health · 2025Article
- Effects of simulated smoke condensate generated from combustion of selected military burn pit contents on human airway epithelial cells.Particle and fibre toxicology · 2024Article
- Hormone Therapy and Biological Aging in Postmenopausal Women.JAMA network open · 2024Article
- Article
- The embodiment of parental death in early life through accelerated epigenetic aging: Implications for understanding how parental death before 18 shapes age-related health risk among older adults.SSM - population health · 2024Article
- Parental Divorce in Childhood and the Accelerated Epigenetic Aging for Earlier and Later Cohorts: Role of Mediators of Chronic Depressive Symptoms, Education, Smoking, Obesity, and Own Marital Disruption.Journal of population ageing · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Cigarette smoking is among the leading risk factors for mortality and morbidity. While men have a higher smoking prevalence, mechanistic experiments suggest that women are at higher risk for health problems due to smoking. Moreover, the comparison of smoking effects on multiple conditions and mortality for men and women has not yet been done in a population-based group with race/ethnic diversity. We used proportional hazards models and restricted mean survival time to assess differences in smoking effects by sex for multiple health outcomes using data from the U.S. Health and Retirement Study (HRS), a population-representative cohort of individuals aged 50+ (n = 22,708, 1992-2014). Men had experienced more smoking pack-years than women (22.0 vs 15.6 average pack-years). Age of death, onset of lung disorders, heart disease, stroke, and cancer showed dose-dependent effects of smoking for both sexes. Among heavy smokers (>28 pack-years) women had higher risk of earlier age of death (HR = 1.3, 95%CI:1.03-1.65) and stroke (HR = 1.37, 95%CI:1.02-1.83). Risk of cancer and heart disease did not differ by sex for smokers. Women had earlier age of onset for lung disorders (HR = 2.83, 95%CI:1.74-4.6), but men risk due to smoking were higher (Smoking-Sex interaction P<0.02) than women. Passive smoke exposure increased risk of earlier heart disease (HR = 1.33, 95%CI:1.07-1.65) and stroke (HR:1.54, 95%CI:1.07-2.22) for non-smokers, mainly in men. Smoking cessation after 15 years partially attenuated the deleterious smoking effects for all health outcomes. In sum, our results suggest that women are more vulnerable to ever smoking for earlier death and risk of stroke, but less vulnerable for lung disorders. From an epidemiological perspective, sex differences in smoking effects are important considerations that could underlie sex differences in health outcomes. These findings also encourage future mechanistic experiments to resolve potential mechanisms of sex-specific cigarette smoke toxicity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.