Smoking as a risk factor for accident death: A meta-analysis of cohort studies

Bruce N. Leistikow, Daniel C. Martin, Jeffrey Jacobs, David M Rocke, Kyle Noderer

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


This meta-analysis discusses the consistency, strength, dose-response, independence, and generalizability of published cohort data on accident death relative risks in smokers. To locate data, three authors independently searched MEDLINE, and bibliographies of the pertinent studies found, for data which allowed estimation of an appropriate cigarette smoker accident death relative risk (and 95% confidence interval). Relative risks and dose-response were summarized by fixed effects and Poisson modeling, respectively. Four pertinent cohort studies including eight populations were located. Cigarette smoking predicted summary accident death relative risks of 1.51 (95% confidence interval 1.27-1.78) versus never smokers and 1.35 (1.17-1.57) versus ex-smokers. Summary dose-response trends were significant (P = 0.0000) versus never or least smoking referents. In individual studies, the smoking/accident death association persisted after adjustment or, in effect stratification, for age, race, sex, and occupation: occupation and time period; or numerous cardiac risk factors. This meta-analysis found significant, consistent, dose-response, often strong and independent (of age, race, and sex), prospective associations of smoking with accident death, internationally. Further studies and warnings of the smoking/accident death associations seem merited

Original languageEnglish (US)
Pages (from-to)397-405
Number of pages9
JournalAccident Analysis and Prevention
Issue number3
StatePublished - May 2000


  • Accident death
  • Meta-analysis
  • Risk factor
  • Smoking

ASJC Scopus subject areas

  • Chemical Health and Safety
  • Safety, Risk, Reliability and Quality
  • Public Health, Environmental and Occupational Health
  • Human Factors and Ergonomics
  • Law
  • Safety Research
  • Transportation


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