Evidence map›Paper›PMID 39994694›Full record

ArticleBMC medicine2025

Relationship of tobacco smoking to cause-specific mortality: contemporary estimates from Australia.

Grace Joshy, Kay Soga, Katherine A Thurber, Sam Egger, Marianne F Weber, Peter Sarich, Jennifer Welsh, Rosemary J Korda, Amelia Yazidjoglou, Mai T H Nguyen and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Cigarette smoke modulates virulence-related properties and host immune responses inFrontiers in cellular and infection microbiology · 2026
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Grace JoshyNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia. Grace.Joshy@anu.edu.au.
Kay SogaNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Katherine A ThurberNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Sam EggerThe Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, NSW, Australia.
Marianne F WeberThe Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, NSW, Australia.
Peter SarichThe Daffodil Centre, The University of Sydney, A Joint Venture With Cancer Council NSW, Sydney, NSW, Australia.
Jennifer WelshNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Rosemary J KordaNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Amelia YazidjoglouNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Mai T H NguyenNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Ellie PaigeNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.
Michelle GourleyBurden of Disease and Mortality Unit, Australian Institute of Health and Welfare, Canberra, Australia.
Karen CanfellSydney School of Public Health, University of Sydney, Sydney, Australia.
Emily BanksNational Centre for Epidemiology and Population Health (NCEPH), The Australian National University, Acton, Canberra, ACT, 2601, Australia.

Funding

National Health and Medical Research Council 1136128, 1156276, 1194679National Heart Foundation of Australia 107210
6 · The paper itself

Abstract

backgroundTobacco industry activities and reduced smoking prevalence can foster under-appreciation of risks and under-investment in tobacco control. Reliable evidence on contemporary smoking impacts, including cause-specific mortality and attributable deaths, remains critical.

methodsProspective study of 178,169 cancer- and cardiovascular-disease-free individuals aged ≥ 45 years joining the 45 and Up Study in 2005-2009, with linked questionnaire, hospitalisation, cancer registry and death data to November 2017. Cause-specific mortality hazard ratios (HR) by smoking status, intensity and recency were estimated, adjusted for potential confounding factors. Population attributable fractions were estimated.

resultsThere were 13,608 deaths during 9.3 years median follow-up (1.68 M person-years); at baseline, 7.9% of participants currently and 33.6% formerly smoked. Mortality was elevated with current versus never smoking for virtually all causes, including chronic lung disease (HR = 36.32, 95%CI = 26.18-50.40), lung cancer (17.85, 14.38-22.17) and oro-pharyngeal cancers (7.86, 4.11-15.02); lower respiratory infection, peripheral vascular disease, oesophageal cancer, liver cancer and cancer of unknown primary (risk 3-5 times as high); and coronary heart disease, cerebrovascular disease and cancers of urinary tract, pancreas, kidney, stomach and prostate (risk at least two-fold); former versus never-smoking demonstrated similar patterns with attenuated risks. Mortality increased with smoking intensity, remaining appreciable for 1-14 cigarettes/day (e.g. lung cancer HR = 13.00, 95%CI = 9.50-17.80). Excess smoking-related mortality was largely avoided with cessation aged < 45 years. In 2019, 24,285 deaths (one-in-every-six deaths, 15.3%), among Australians aged ≥ 45 years, were attributable to tobacco smoking.

conclusionsSmoking continues to cause a substantial proportion of deaths in low-prevalence settings, including Australia, highlighting the importance of accelerated tobacco control.

Indexed as

Tobacco SmokingAgedAustraliaCause of DeathFemaleHumansMaleMiddle AgedProspective StudiesRisk FactorsCause of deathFatal burden of diseaseSmokingTobacco

Identifiers

PMID39994694
PMCPMC11854379

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Registered trials

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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.