Health effects associated with smoking: a Burden of Proof study
Xiaochen Dai, Gabriela Gil, Marissa B Reitsma, Noah Ahmad, Jason A Anderson, Catherine Bisignano, Sinclair Carr, Rachel Feldman, Simon I Hay, Jiawei He, Vincent C Iannucci, Hilary R. Lawlor, Matthew J. Malloy, Laurie B. Marczak, Susan A. McLaughlin, Larissa Morikawa, Erin C Mullany, Sneha I. Nicholson, Erin M O'Connell, Chukwuma Okereke, Reed J D Sorensen, Joanna L Whisnant, Aleksandr Y. Aravkin, Peng Zheng, Christopher J L Murray, Emmanuela Gakidou
Abstract
As a leading behavioral risk factor for numerous health outcomes, smoking is a major ongoing public health challenge. Although evidence on the health effects of smoking has been widely reported, few attempts have evaluated the dose-response relationship between smoking and a diverse range of health outcomes systematically and comprehensively. In the present study, we re-estimated the dose-response relationships between current smoking and 36 health outcomes by conducting systematic reviews up to 31 May 2022, employing a meta-analytic method that incorporates between-study heterogeneity into estimates of uncertainty. Among the 36 selected outcomes, 8 had strong-to-very-strong evidence of an association with smoking, 21 had weak-to-moderate evidence of association and 7 had no evidence of association. By overcoming many of the limitations of traditional meta-analyses, our approach provides comprehensive, up-to-date and easy-to-use estimates of the evidence on the health effects of smoking. These estimates provide important information for tobacco control advocates, policy makers, researchers, physicians, smokers and the public.