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Chunk #28 — Discussion

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Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence.
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These findings are virtually identical to those on the contemporary risks of smoking from the UK and US, where the RR of all-cause mortality in current versus never-smokers has been consistently reported at 2.8 to 3.0 [3,21-23] and similar to a recent report from Japan [24]. The finding of similar RRs among smokers across successive birth cohorts in this study indicates that, in common with these countries, it is likely that the full mortality impacts of smoking are being realised among smokers in Australia. The evolution of increasing smoking-attributable mortality over time is well documented, with RRs of all-cause mortality in current versus never-smokers of around 1.4 to 1.8 in the 1960s to 2.1 to 2.3 in the 1980s [3,6], corresponding to up to around one-third and one-half of the deaths in smokers being attributable to smoking, respectively. The findings from this and contemporary estimates from the US and UK indicate that up to two-thirds of deaths in smokers in the 21st century in these settings are likely to have been caused by smoking [3,6,23]. The progressive increase in RRs