Smoking, smoking cessation and aortic arch calcification in older Chinese: The Guangzhou Biobank Cohort Study

Objective: To study the association between smoking, smoking cessation and aortic arc calcification (AAC) in an older Chinese population. Methods: A total of 3022 men and 7279 women aged 50-85 years were recruited and received a medical check-up including measurement of fasting plasma vascular risk factors. Two radiologists reviewed the posterior-anterior plain chest X-ray radiographs and assessed AAC together. Information on smoking status, socioeconomic and lifestyle factors was collected. Results: The crude prevalence of AAC in men (38.58%) was lower than that in women (41.37%). The adjusted odds ratios of AAC increased significantly across never, ex- and current smokers in both genders. Dose-response relationships were observed among current smokers for smoking amount (cigarettes/day), smoking duration (years) and cigarette pack-years in both genders (all p < 0.01). The odds ratios decreased significantly (p = 0.018) with longer duration of quitting in light ex-smoking men (<23.5 pack-years) but showed no beneficial effect (p = 0.72) for heavy ex-smokers (≥23.5 pack-years). Conclusion: Smoking increased the risk of AAC in Chinese, while smoking cessation decreased the risk only in male light ex-smokers. Chest X-ray is a cheap and simple method to detect AAC, which should be an important warning signal for immediate smoking cessation.