Evidence map›Paper›PMID 41495754›Full record

ArticleBMC medicine2026

Mortality and morbidity burden associated with smoking: evidence from a 1.6 million cohort in Hong Kong.

Boyuan Wang, Tingting Chen, Ming Hin Lee, Ka Hung Chan, Sophia Siu Chee Chan, Ian Chi Kei Wong, Eric Yuk Fai Wan

Abstract read
In one paragraph

Article in BMC medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

7 authors.

Boyuan Wang *Department of Family Medicine and Primary Care, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Tingting Chen *Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Ming Hin LeeDepartment of Family Medicine and Primary Care, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Ka Hung ChanIndependent epidemiologist, Hong Kong Special Administrative Region, China.
Sophia Siu Chee ChanSchool of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Ian Chi Kei WongDepartment of Pharmacology and Pharmacy, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Eric Yuk Fai WanDepartment of Family Medicine and Primary Care, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong Special Administrative Region, China. yfwan@hku.hk.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExisting evidence on the disease burden of smoking is often outdated and incomprehensive, particularly in Asia, which plays a pivotal role in the global tobacco control community. This study aimed to provide an updated and comprehensive estimate of the mortality and morbidity burden associated with smoking in Hong Kong.

methodsThis retrospective cohort study included adults with smoking status information recorded in the Hong Kong Hospital Authority database between 1 January 2008 and 31 December 2012. Subjects were classified into never-smokers, ex-smokers, and current smokers. The primary outcome was all-cause mortality. Cox proportional hazards regression, adjusted with fine stratification weighting and key baseline characteristics, yielded hazard ratios (HRs) with 95% confidence intervals (CIs) for each outcome.

resultsOf the 1,571,065 individuals analyzed, there were 14.3% current smokers, 11.9% ex-smokers, and 73.8% never-smokers. After a median follow-up of 11.7 years, 61,198 current smokers, 45,918 ex-smokers, and 220,947 never-smokers died. Significantly higher risks of all-cause mortality were observed among current smokers (HR [95% CI]: 1.53 [1.51-1.56]) and ex-smokers (1.33 [1.31-1.35]) than among never-smokers. Current and ex-smoking were positively associated with the incidences of 76 and 60 out of 115 morbidities, respectively. Strong associations were observed between smoking and increased risks of suicide (intentional self-harm), mental, and behavioral disorders due to psychoactive substance use and alcohol use, particularly among current smokers. Notably, these risks were higher in females than in males for all three outcomes. Additionally, females demonstrated higher risks of all-cause mortality, pneumonia, chronic obstructive pulmonary disease, and asthma compared to males.

conclusionsSmoking remains a substantial burden on the healthcare system in Hong Kong, which may still be underestimated due to Hong Kong's relatively less advanced stage in the tobacco epidemic compared to some Western countries, where the full hazards of smoking have already manifested more prominently.

Indexed as

SmokingAdultAgedCohort StudiesFemaleHong KongHumansMaleMiddle AgedMorbidityRetrospective StudiesRisk FactorsYoung AdultCohort studyDisease burdenHong KongMortalitySmoking

Identifiers

PMID41495754
PMCPMC12870220

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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.