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Smoking in adolescence and young adulthood and mortality in later life: prospective observational study
  1. P McCarrona,
  2. G Davey Smitha,
  3. M Okashaa,
  4. J McEwenb
  1. aDepartment of Social Medicine, University of Bristol, University of Bristol, Canynge Hall, Whiteladies Road, Bristol BS8 2PR, UK, bDepartment of Public Health, University of Glasgow
  1. Dr McCarron (mccarrop{at}

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As experimentation with smoking occurs overwhelmingly in adolescence, a major objective of government strategy is to reduce smoking among young people.1 However, most studies of the association between mortality and smoking have relied on data for people whose smoking behaviour was recorded in middle age; teenagers and young adults may not see the relevance of messages derived from these studies or may feel that they are to some extent immune from the health damaging effects of smoking. Few studies have examined the association between mortality and smoking behaviour in early life. In US college students who reported their smoking behaviour between 1916 and 1950 risk of cancer and cardiovascular disease (CVD) was increased among individuals who smoked in young adulthood2 while in a large prospective study of women's health participants who started smoking before the age of 15 years had the highest risks for total mortality, CVD mortality and deaths from injury.3 The first of these studies did not fully analyse the role of potential confounders while the second relied on recall of past smoking experience. To investigate this issue further we examined the association …

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  • Funding: Chest Heart and Stroke (Scotland), Stroke Association, NHS Management Executive, Cardiovascular Disease and Stroke Research and Development Initiative.

  • Conflicts of interest: none.