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OBJECTIVE: To assess the usefulness of the general framework of the smoking epidemic. METHODS: We use lung cancer mortality as an indicator for smoking intensity and employ an age-cohort model to accommodate the long-lasting and cumulative effects. RESULTS: Dutch males have higher risks than Danish males, but the risks for the younger cohorts have been declining faster in the Netherlands than in Denmark. Danish women have about twice the risk of Dutch women, and in both countries the risks for the younger cohorts are increasing. The smoking epidemic began at about the same time in Denmark and the Netherlands. Dutch males, however, seem to have smoked more but to have given up smoking more quickly than Danish males. Danish females were quicker to take up smoking than Dutch females. CONCLUSIONS: Within the general framework of the smoking epidemic, differences in timing and levels can produce large differences between countries. For the purposes of assessing smoking-related risks, including projections, the smoking epidemic framework therefore has to be tailored to each study population.

Background: Promotion of a healthy lifestyle and non-pharmacological interventions in the treatment of chronic obstructive pulmonary disease (COPD) has received great attention in recent decades. The aim of this study was to investigate trends in leisure time physical activity (PA), smoking, alcohol consumption and body mass index (BMI) from 2000 to 2010 in Danish individuals with and without COPD.Methods: Analyses were based on data provided by The Danish Health and Morbidity's three cross-sectional surveys from 2000, 2005 and 2010. Data compromised level of leisure time PA, smoking, alcohol consumption, BMI and sociodemographic characteristics. Participants aged 25 years or older with and without COPD were included in the analyses.Results: In multiple logistic regression analyses, odds ratio (OR) of being physically active in the leisure time in 2010 compared to 2000 was 1.70 (95 % CI: 1.28-2.26), p < 0.001, and 1.32 (1.22-1.43), p < 0.001, in participants with and without COPD, respectively. Being a non-smoker in 2010 compared to 2000 was associated with an OR of 1.41 (1.07-1.85), p = 0.015, and 1.73 (1.63-1.85), p < 0.001, in participants with and without COPD. The OR of not exceeding national recommended alcohol limits was 0.64 (0.45-0.93), p = 0.020, and 1.19 (1.09-1.29), p < 0.001, in participants with and without COPD. In a multiple linear regression analysis, the time frame from 2000 to 2010 was associated with an increased BMI of 1.18 kg · m(-2) (0.52-1.84), p < 0.001, and 0.74 kg · m(-2) (0.63-0.86), p < 0.001, in participants with and without COPD. The COPD participants with higher levels of education and/or living in a marriage or a relationship were more likely to be physically active, non-smoking and not exceeding the recommended alcohol limits.Conclusion: From the 2000 to 2010, Danish individuals aged 25 years with and without COPD, increased their leisure time PA level and reduced smoking. Lower socioeconomic status was associated with a reduced level of PA, smoking and an increased alcohol intake. Future national health campaigns and treatment strategies need to target this socioeconomic impact. The reported increased PA level and reduced smoking may have important implications in relation to a reduced morbidity and mortality risk in Danish patients with COPD. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to evaluate the association between experienced physical violence and health-related quality of life (HRQoL) by comparing self-reported health status for individuals with and without experience of physical violence. Our hypothesis was that individuals exposed to violence would experience worse HRQoL than non-exposed individuals. We tested whether men and women and different age groups experience similar reductions in HRQoL, and the extent to which such differences might be associated with social circumstances and lifestyle conditions. Finally, we explored the HRQoL consequences of exposure to violence in a longer time perspective. Methods: We used data from self-completed questionnaires in two Danish nationally representative, cross-sectional health interview surveys. Exposure to violence was indicated through specific survey questions (Straus' conflict tactics scale) enquiring about different types of violence during the last 12 months. Health status of respondents was elicited by the EQ-5D and SF-36 questionnaires. The health status profiles were converted to health score indexes using the Danish algorithm for EQ-5D and the revised Brazier algorithm for SF-6D. Differences in score indexes between the exposed and non-exposed individuals were explored separately for men and women using ordinary least square regression with four age categories as explanatory variables. Results: In the 2000 and 2005 surveys, respectively, 4.9% and 5.7% of respondents indicated that they had been exposed to physical violence within the last 12 months. Exposure to violence was more prevalent in the younger age groups and more prevalent for men than women. Respondents exposed to violence had lower score indexes on both the EQ-5D and the SF-6D compared with the non-exposed. Respondents who reported exposure to violence in both 2000 and 2005 reported lower HRQoL than individuals who only reported exposure in one of the surveys. Conclusions: The results of this study provide evidence for an association between exposure to physical violence and reduction in health-related quality of life. [ABSTRACT FROM AUTHOR]

Background: While life expectancy quantifies average length of life, health expectancy represents the average lifetime in different health states and offers the possibility to evaluate quality of life with respect to health. The purpose of the study was to estimate changes in health expectancy in Denmark from 1987 to 2000 and to assess theories about the relation between increased total lifetime and lifetime in various health states. Methods: Data on health status derived from the Danish Health Interview Surveys carried out in 1987, 1991, 1994 and 2000 were combined with life-table data. Expected lifetime in selfrated good health, life expectancy without longstanding illness and disabilityfree life expectancy were estimated by Sullivan's method. Results: In 1987, the life expectancy of a 65-year-old man was 14.1 years, 8.9 years of which were expected to be disabilityfree. In 2000, life expectancy had increased to 15.0 years, 11.3 years of which were disabilityfree. Thus, life expectancy had increased by 0.9 years, whereas disabilityfree life expectancy had increased by 2.4 years. Among 65-year-old women, life expectancy had increased by 0.2 years and disabilityfree life expectancy by 1.1 years. Expected lifetime in selfrated good health had also improved, but the trend in life expectancy without longstanding illness went in the opposite direction, and expected lifetime with longstanding illness had increased. Conclusion: The recent rise in life expectancy in Denmark after many years of stagnation appears to be accompanied by generally improved health status among the elderly, but health expectancy trends depend on the health indicator chosen. [ABSTRACT FROM AUTHOR]

Background: The purpose of the study was to determine trends in social inequality in mortality and life expectancy in Denmark. Methods: The study was based on register data on educational level and mortality during the period 1981-2005 and comprised all deaths among Danes aged 30-60. Sex- and age-specific death rates for each of three levels of education were calculated and age-standardized to allow comparisons over time and between groups. As data obtained since 1996 included ages up to 74, partial life expectancy (i.e. expected lifetime of 30-year-olds before the age of 75) was calculated for the period 1996-2005. Results: Between 1981 and 2005, the difference in death rates between people aged 30-60 with low and high educational level increased by two-thirds for men and was doubled for women. During the period 1996-2005, the gap in partial life expectancy from age 30 to 75 between people with low and high educational level increased by 0.3 years. Conclusion: During the past 25 years, the social gap in mortality has widened in Denmark. In particular, women with a low educational level have been left behind. [ABSTRACT FROM AUTHOR]