A COHORT APPROACH TO TOBACCO USE AND MORTALITY - THE CASE OF QUEBEC

Background. Cigarette smoking is the No. 1 cause of premature death am ong Canadians, However, tobacco consumption dropped by 35% in Canada d uring the 1980s.Methods. Using data collected during a Quebec health s urvey, we evaluated the prevalences of tobacco use by birth cohort. Si nce mortality has been decreasing for both sexes, we computed gender-s pecific cohort mortality indices for tobacco-related causes of death, In the analysis, we took into account the inevitable time lag between adopting the behavior and becoming the victim of a smoking-attributabl e disease. Results. Results indicate a systematic decrease in tobacco use from older male cohorts to younger ones across all ages; however, for females an increase in tobacco use has been observed from one coho rt to the next but there seems to be hope for a future trend toward br eaking the habit. While a decline in tobacco-related mortality has bee n observed among men (e.g., death from ischemic heart disease), female lung cancer mortality increased considerably. Finally, we present an indicator measuring the years of potential life lost for some tobacco- related causes of death. Conclusions. The cohort approach allows us to observe birth-cohort-specific trends, thereby more easily relating pa st behavior to current mortality levels. In terms of prevention, incre asing female mortality from lung cancer should become a major concern and a motivator in the fight against tobacco use. (C) 1996 Academic Pr ess, Inc.