Background Rapid population ageing has raised the proportion of older former smokers considerably, but a comprehensive assessment tool of former smoking-related health risks is absent. Objective We utilised the large-scale data of UK Biobank and ESTHER study to build a former smoking score (FSS) for older former smokers using three major former smoking traits: pack-years, smoking duration and time since smoking cessation. Design UK Biobank and ESTHER study are two cohorts of older adults with 502,528 and 9,940 participants from the UK and Germany, respectively. Methods Smoking history and covariates were retrieved from the self-administrated questionnaires and mortality and morbidity data were obtained through regular linkages to hospital records. Results We constructed the FSS based on the 94,446 former smokers of UK Biobank by retrieving the averaged effect estimates of each trait with a 100-time random sampling. This score was robustly associated with higher risks of mortality and incidence of major smoking-related diseases, outperforming each trait. In the validation panel of 2,683 former smokers from ESTHER study, the FSS was highly predictive of mortality and morbidities. Particularly, compared with the 1st quartile of the FSS group, the 4th quartile group had 114.1, 104.5 and 158.9% higher risks of all-cause, CVD and cancer mortality, respectively, and 41.9, 31.9, 52.4 and 831.3% higher risks of incident CVD, type 2 diabetes, any cancers and lung cancer, respectively. Conclusions Our study demonstrates the large potential of refined risk assessment of former smokers by more comprehensive consideration of the major traits of former smoking.

中文翻译：

---

基于吸烟史评分的老年前吸烟者的死亡率和发病风险预测：来自英国生物银行和 ESTHER 队列的证据

背景 快速的人口老龄化已大大增加了老年前吸烟者的比例，但缺乏对前吸烟相关健康风险的综合评估工具。目的 我们利用 UK Biobank 和 ESTHER 研究的大规模数据，使用三个主要的既往吸烟特征：包年、吸烟持续时间和自戒烟后的时间，为年长的前吸烟者建立前吸烟评分 (FSS)。Design UK Biobank 和 ESTHER 研究是两组老年人，分别有来自英国和德国的 502,528 和 9,940 名参与者。方法 从自我管理的问卷中检索吸烟史和协变量，并通过与医院记录的定期链接获得死亡率和发病率数据。结果我们构建了基于94的FSS，通过 100 次随机抽样检索每个性状的平均效应估计值，对英国生物银行的 446 名前吸烟者进行调查。该分数与较高的死亡率风险和主要吸烟相关疾病的发病率密切相关，优于每个特征。在来自 ESTHER 研究的 2,683 名前吸烟者的验证小组中，FSS 高度预测死亡率和发病率。特别是，与 FSS 组的第 1 个四分位数相比，第 4 个四分位数组的全因死亡率、CVD 死亡率和癌症死亡率分别高 114.1%、104.5% 和 158.9%，事件风险分别高 41.9%、31.9%、52.4% 和 831.3%分别是 CVD、2 型糖尿病、任何癌症和肺癌。