Tuesday, 15 February 2011

Health risks in women smokers

On recent data, a woman born in 2000 who smokes will have the risk of dying from the various outcomes given in the plot. Different coloured circles represent various classes of outcome (cancer, vascular etc), whereas each particular outcome is represented by a different circle. Time is shown for the dates 2035 - 2075*, representing the ages 35 - 75 years old. The risks are represented as the ratio of deaths of smoker to non-smoker women over the next 10 years. This 10 year time frame is easier to understand than "lifetime" risks, and allows us to see how risks change over time. The ratios are plotted against the number of deaths per 1000 (N per 1000) women smokers for each outcome, and the coloured circles representing outcomes move over time (age/date).
The dynamic plot shows that initially in the first 15 years (age 50 at 2050) heart disease and stroke increase to a ratio of about 4:1. Lung cancer increases, slightly delayed, from about 5 years (2040), reaching a maximum at 15 years (2050) of 14:1, at which time chronic obstructive pulmonary disease (COPD) starts to increase and finally exceeds the ratio for lung cancer at age 75 (ratio 10:1 & 8:1 respectively), and each of these conditions accounting for about 60 deaths of 1000 women smokers. After the initial increased ratios for vascular disease, these ratios decrease towards age 75, till they are no different from non-smokers (ratio approx. 1:1). However, at age 75 heart disease accounts for the largest proportion of deaths, about 100 per 1000 women over the next 10 years of life.

The plotted data are based on the table from Woloshin, S., Schwartz, L.M., & Welch, H.G. (2008). The risk of death by age, sex, and smoking status in the United States: Putting health risks in context. Journal of the National Cancer Institute, 100: 845–853. http://jnci.oxfordjournals.org/content/100/12/845
The data and R code used are shown here.
A non-smoker has smoked less than 100 cigarettes in her life and a current smoker has smoked at least 100 cigarettes or more in her life and smokes (any amount) now. Where there is little data (i.e. where there are fewer than 1 per 1000 deaths) then the ratios are shown as 0.
* I tried to show these as ages rather than dates, but gvismotionchart doesn't seem to allow this option - please let me know if you know better!

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