Introduction
Worldwide, an estimated 189 million adults smoke tobacco “occasionally” but not every
day. Yet few studies have examined the health risks of non-daily smoking.
Methods
Data from the 1991, 1992, and 1995 U.S. National Health Interview Surveys, a nationally
representative sample of 70,913 U.S. adults (aged 18–95 years) were pooled. Hazard
ratios and 95% CIs for death through 2011 were estimated from Cox proportional hazards
regression using age as the underlying time metric and stratified by 5-year birth
cohorts in 2017.
Results
Non-daily smokers reported smoking a median of 15 days and 50 cigarettes per month
in contrast to daily smokers who smoked a median of 600 cigarettes per month. Compared
with never smokers, lifelong nondaily smokers who had never smoked daily had a 72%
higher mortality risk (95% CI=1.36, 2.18): higher risks were observed for cancer,
heart disease, and respiratory disease mortalities. Higher mortality risks were observed
among lifelong non-daily smokers who reported 11–30 (hazard ratio=1.34, 95% CI=0.81,
2.20); 31–60 (hazard ratio=2.02, 95% CI=1.17, 3.29); and >60 cigarettes per month
(hazard ratio=1.74, 95% CI=1.12, 2.72) than never smokers. Median life-expectancy
was about 5 years shorter for lifelong non-daily smokers than never smokers. As expected,
daily smokers had even higher mortality risks (hazard ratio=2.50, 95% CI=2.35, 2.66)
and shorter survival (10 years less).
Conclusions
Although the mortality risks of non-daily smokers are lower than daily smokers, they
are still substantial. Policies should be specifically directed at this growing group
of smokers.
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Article info
Publication history
Published online: October 24, 2018
Identification
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Published by Elsevier Inc. on behalf of American Journal of Preventive Medicine.
