Systemic review project
*For correspondence:
Prabhat.jha@utoronto.ca
Competing interest: See
page 36
Funding: See page 36
Received: 09 July 2019
Accepted: 14 February 2020
Published: 24 March 2020
Reviewing editor: Eduardo
Franco, McGill University,
Canada
Copyright Jha. This article is
distributed under the terms of
the Creative Commons
Attribution License, which
permits unrestricted use and
redistribution provided that the
original author and source are
credited.
The hazards of smoking and the benefits
of cessation: A critical summation of the
epidemiological evidence in high-income
countries
Prabhat Jha*
Centre for Global Health Research, Dalla Lana School of Public Health and Unity
Health, Toronto, University of Toronto, Ontario, Canada
Abstract In high-income countries, the biggest cause of premature death, defined as death
before 70 years, is smoking of manufactured cigarettes. Smoking-related disease was responsible
for about 41 million deaths in the United States, United Kingdom and Canada, cumulatively, from
1960 to 2020. Every million cigarettes smoked leads to one death in the US and Canada, but
slightly more than one death in the UK. The 21st century hazards reveal that smokers who start
smoking early in adult life and do not quit lose a decade of life expectancy versus non-smokers.
Cessation, particularly before age 40 years, yields large reductions in mortality risk. Up to two-
thirds of deaths among smokers are avoidable at non-smoking death rates, and former smokers
have about only a quarter of the excess risk of death compared to current smokers. The gap
between scientific and popular understanding of smoking hazards is surprisingly large.
Overview
I summarize the causative role of smoking for the most common causes of death among adults in
high-income countries, drawing on data from Canada, the United States (US) and the United King-
dom (UK). The main objective of this analysis is to review the hazards of smoking and the benefits of
cessation. I do so by examining the cause, nature and extent of tobacco-related diseases in high-
income countries between 1960 and 2020. The review has seven main conclusions.
First, in much of Europe and North America, the biggest cause of premature death, defined as
death before 70 years, is smoking of manufactured cigarettes. Smoking as an important cause of
many diseases in many populations has been recognized widely in the scientific literature for the last
five decades. However, three surprising features of health hazards of smoking have been established
reliably only since about 2012. The first feature is that risk of developing disease among smokers is
big. The second feature is that for smokers to develop these big risks, they need to start smoking
early in adult life and to continue smoking. If smokers don’t start early in life, their risks are substan-
tially smaller. Third, if smokers stop smoking before they develop some serious disease, then their
risks are subst
Template for Systematic Reivew
STUDY TITLE:
INVESTIGATOR(S): names
ABSTRACT
RESEARCH QUESTION
OBJECTIVES AND SPECIFIC AIM(S):
BACKGROUND
RESEARCH METHODS
Eligibility criteria:
Types of studies
Types of participants
Types of interventions ((if applicable)
Types of outcome measures
Search Strategy and Information Sources
Methods of the Review (data collection process):
Assessment of methodological quality
Data extraction
Data synthesis
REVIEW RESULTS
Description of the selected studies
Methodological quality
Results of individual studies:
DISCUSSION
Limitations
Conclusions
Implications for practice
Implications for research
REFERENCES: (USE ENDNOTE)
3/16/2022 Page 2 of 2
2
PLEASE USE THIS PICOT, OBJECTVE, AND STATEMENT BELOW TO CPMPLETE THE ATTACHED TEMPLATE
Question 1: PICOT
P= The research will use secondary research conducted within the last 10 years.
I= A systematic research review method will be applied to provide a review of the existing research regarding the topic.
C= Comparison between the mortality rates between active smokers and non-smokers who quit smoking before age 4
O= Determine impacts of smoking on mortality rates of individuals.
T= The time needed for the research is one and half months to complete an adequate review of existing research.
Question 2: Objective
Determine the risks of smoking and advantages of ceasing the habit.
Statement
Due to the persistence of the smoking behaviors within the contemporary society, there is an increase in awareness regarding the hazardousness of the behavior. The research aims at increasing advocacy against by incorporating various research results regarding adverse health impacts of smoking to provide a more generalizable result for reducing smoking behaviors, especially among the young populations.
Please use the attached article to prepare 17-18 slide power points with 6 references
Please use the attached article to write 6-8 pages paper APA format summarizing the article, the objective of the article, the population targeted and the benefits or impact of smoking . 4 references.
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