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Smoking

Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb

Type
Lifestyle Risk Factor
ID
PH393
Version ID
786
Data Sources
Valid event data range
01/01/2001 - 31/12/2013
Sex
Female, Male
Agreement Date
2017-05-01
Coding system
Read codes v2
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

PURPOSE:

Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves.

METHODS:

During 2001-2013, a total of 385 general practices in England contributed data to the Clinical Practice Research Datalink with linkage to Office for National Statistics mortality records. We identified 30,017 persons aged 15 to 64 years with a recorded episode of self-harm. We estimated the relative risks of all-cause and cause-specific natural and unnatural mortality using a comparison cohort of 600,258 individuals matched on age, sex, and general practice.

RESULTS:

We found an elevated risk of dying prematurely from any cause among the self-harm cohort, especially in the first year of follow-up (adjusted hazard ratio for that year, 3.6; 95% CI, 3.1-4.2). In particular, suicide risk was especially high during the first year (adjusted hazard ratio, 54.4; 95% CI, 34.3-86.3); although it declined sharply, it remained much higher than that in the comparison cohort. Large elevations of risk throughout the follow-up period were also observed for accidental, alcohol-related, and drug poisoning deaths. At 10 years of follow-up, cumulative incidence values were 6.5% (95% CI, 6.0%-7.1%) for allcause mortality and 1.3% (95% CI, 1.2%-1.5%) for suicide.

CONCLUSIONS:

Primary care patients who have harmed themselves are at greatly increased risk of dying prematurely by natural and unnatural causes, and especially within a year of a first episode. These individuals visit clinicians at a relatively high frequency, which presents a clear opportunity for preventive action. Primary care patients with myriad comorbidities, including self-harming behavior, mental disorder, addictions, and physical illnesses, will require concerted, multipronged, multidisciplinary collaborative care approaches.

Publications

  • Matthew J Carr, Darren M Ashcroft, Evangelos Kontopantelis, David While, Yvonne Awenat, Jayne Cooper, Carolyn Chew-Graham, Nav Kapur, Roger T Webb, Premature Death Among Primary Care Patients With a History of Self-Harm. Annals of Family Medicine, 15(3), 2017.

Clinical Code List

Rows: 62
Code Description Entity type Category Coding System (Read)
137..00 Tobacco consumption res41: smoking diagnostic Read
137..11 Smoker - amount smoked res41: smoking diagnostic Read
1371.00 Never smoked tobacco res41: smoking diagnostic Read
1371.11 Non-smoker res41: smoking diagnostic Read
1372.00 Trivial smoker - < 1 cig/day res41: smoking diagnostic Read
1372.11 Occasional smoker res41: smoking diagnostic Read
1373.00 Light smoker - 1-9 cigs/day res41: smoking diagnostic Read
1374.00 Moderate smoker - 10-19 cigs/d res41: smoking diagnostic Read
1375.00 Heavy smoker - 20-39 cigs/day res41: smoking diagnostic Read
1376.00 Very heavy smoker - 40+cigs/d res41: smoking diagnostic Read
1377.00 Ex-trivial smoker (<1/day) res41: smoking diagnostic Read
1378.00 Ex-light smoker (1-9/day) res41: smoking diagnostic Read
1379.00 Ex-moderate smoker (10-19/day) res41: smoking diagnostic Read
137A.00 Ex-heavy smoker (20-39/day) res41: smoking diagnostic Read
137B.00 Ex-very heavy smoker (40+/day) res41: smoking diagnostic Read
137C.00 Keeps trying to stop smoking res41: smoking diagnostic Read
137D.00 Admitted tobacco cons untrue ? res41: smoking diagnostic Read
137E.00 Tobacco consumption unknown res41: smoking diagnostic Read
137F.00 Ex-smoker - amount unknown res41: smoking diagnostic Read
137G.00 Trying to give up smoking res41: smoking diagnostic Read
137H.00 Pipe smoker res41: smoking diagnostic Read
137I.00 Passive smoker res41: smoking diagnostic Read
137J.00 Cigar smoker res41: smoking diagnostic Read
137K.00 Stopped smoking res41: smoking diagnostic Read
137K000 Recently stopped smoking res41: smoking diagnostic Read
137L.00 Current non-smoker res41: smoking diagnostic Read
137M.00 Rolls own cigarettes res41: smoking diagnostic Read
137N.00 Ex pipe smoker res41: smoking diagnostic Read
137O.00 Ex cigar smoker res41: smoking diagnostic Read
137P.00 Cigarette smoker res41: smoking diagnostic Read
137P.11 Smoker res41: smoking diagnostic Read
137Q.00 Smoking started res41: smoking diagnostic Read
137Q.11 Smoking restarted res41: smoking diagnostic Read
137R.00 Current smoker res41: smoking diagnostic Read
137S.00 Ex smoker res41: smoking diagnostic Read
137T.00 Date ceased smoking res41: smoking diagnostic Read
137U.00 Not a passive smoker res41: smoking diagnostic Read
137V.00 Smoking reduced res41: smoking diagnostic Read
137W.00 Chews tobacco res41: smoking diagnostic Read
137X.00 Cigarette consumption res41: smoking diagnostic Read
137Y.00 Cigar consumption res41: smoking diagnostic Read
137Z.00 Tobacco consumption NOS res41: smoking diagnostic Read
137a.00 Pipe tobacco consumption res41: smoking diagnostic Read
137b.00 Ready to stop smoking res41: smoking diagnostic Read
137c.00 Thinking about stopping smoking res41: smoking diagnostic Read
137d.00 Not interested in stopping smoking res41: smoking diagnostic Read
137e.00 Smoking restarted res41: smoking diagnostic Read
137j.00 Ex-cigarette smoker res41: smoking diagnostic Read
137l.00 Ex roll-up cigarette smoker res41: smoking diagnostic Read
137m.00 Failed attempt to stop smoking res41: smoking diagnostic Read
8CAL.00 Smoking cessation advice res41: smoking diagnostic Read
8H7i.00 Referral to smoking cessation advisor res41: smoking diagnostic Read
8HTK.00 Referral to stop-smoking clinic res41: smoking diagnostic Read
8HkQ.00 Referral to NHS stop smoking service res41: smoking diagnostic Read
8IAj.00 Smoking cessation advice declined res41: smoking diagnostic Read
9NS0200 Referral for smoking cessation service offered res41: smoking diagnostic Read
9km..00 Ex-smoker annual review - enhanced services administration res41: smoking diagnostic Read
9km..11 Ex-smoker annual review res41: smoking diagnostic Read
9kn..00 Non-smoker annual review - enhanced services administration res41: smoking diagnostic Read
9kn..11 Non-smoker annual review res41: smoking diagnostic Read
9ko..00 Current smoker annual review - enhanced services admin res41: smoking diagnostic Read
9ko..11 Current smoker annual review res41: smoking diagnostic Read

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH393/version/786/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH393/version/786/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH393', '786', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH393/version/786/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH393/version/786/export/codes/?format=json
CSV site_root/phenotypes/PH393/version/786/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH393', '786', api_client=client)

Version History

Version
ID
Name Owner Publish date
786 Smoking ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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