A propensity analysis of cigarette smoking and mortality with consideration of the effects of alcohol∗∗Note: This study uses data supplied by the National Heart, Lung, and Blood Institute, National Institutes of Health, United States Department of Health and Human Services, Bethesda, Maryland. The views expressed in this study are those of the authors and do not necessarily reflect the views of the National Heart, Lung, and Blood Institute

Although it is well established that cigarette smoking causes excess mortality, the extent of the increased risk has been challenged because self-selection biases and confounding factors may not have been adequately accounted for in prior studies. We therefore performed a propensity analysis on a population-based cohort. A logistic regression model was used to generate a propensity score for current smoking in 6,099 adults (mean age 46 years, 54% men, 36% current smokers) participating in the National Heart Lung and Blood Institute’s (NHLBI) Lipid Research Clinic Prevalence Study. During 12 years of follow-up, 513 subjects (8%) died. After adjusting for age, current smoking was strongly associated with death (compared with never and former smokers, relative risk [RR] 2.69, 95% confidence interval [CI] 1.98 to 0.64, p