PONE-D-20-20926

Joint effect of alcohol use and tobacco smoke on all-cause mortality and premature death in China: a cohort study

PLOS ONE

Dear Dr. Yan,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please, address the comments from both reviewers for further consideration.

Please submit your revised manuscript by Dec 04 2020 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

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We look forward to receiving your revised manuscript.

Kind regards,

Associate Professor Dr Muhammad Aziz Rahman,

MBBS, MPH, CertGTC, GCHECTL, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: No

Reviewer #2: No

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: This is an interesting paper on the combined effect of alcohol consumption and tobacco use on mortality and premature death in China.

However, I see some major limitations to the paper. I see in your discussion section you have mentioned that the paper is limited by not having information on the amount that participants drunk. This is a major limitation. And the definition of at least once a month seems small. Having moderate, heavy drinking would really add to the paper. Is there some other way of modelling this from other studies/datasets? Also not having information on cause of mortality limits the results of this paper significantly.

Are you able to look at different levels of tobacco use and drinking? Currently the paper only looks at "ever" smoking, 100 cigarettes in their lifetime. It would useful also to look smoking frequency. Is this possible?

The manuscript requires a major edit for grammar. I would note some down but without line numbers it is very difficult to do this.

The term tobacco smoke, isn't quite right. Tobacco smoking is more suitable in most places. The background sentence in the abstract doesn't make sense. Something like "Tobacco smoking and alcohol use have been shown to be associated with several diseases, however few studies have looked at the combined effect of smoking and drinking" may be more suitable.

Abstract in the results you don't need a "the" before confounders.

I would use "sex" rather than "gender" in the manuscript and keep this consistent throughout.

I would find it easier to call the groups: non-smoker/non-drinker, smoker, drinker, smoker/drinker. Define it earlier on, but it is confusing to read as it is.

Discussion, third line down you say non-smoker twice.

Reviewer #2: Be more careful with phrasings that insinuate causality.

Present study is representative cohort design. Due to nature of observational study, the results did not showed causality Causal language (including use of terms such as "effect," "efficacy," "cause," and "x increased y") should be used only for randomized trials. For all other study designs (including meta-analyses of randomized trials), methods and results should be described in terms of association or correlation (eg, "x associated with an increase in y") and should avoid cause-and-effect wording.

Recent, the 4th wave of CHARLS (2018) has been released. The data can be updated using 4 waves from 2011 to 2018.

This study have many language/grammar errors. For example, in the section of results of abstract, ’smoker and drinker increased the odds of premature death’.

Please add the definition of outcome in the section of methods.( Premature death defined as mortality before age 72.7 years in men and 76.9 years in women, which were the average life expectancies in China in 2011).

The authors stated that they used weighted logistic regression. I am looking forward to the code for validating their correctness of analysis.

More sensitivity analysis need to be conducted to show the robustness of results. For example, excluding individuals who had events in the first five years of follow-up to avoid possible inverse causal relationships and excluding individuals who had events in the first ten years of follow-up to avoid possible inverse causal relationships.

Please add the proportion of excluded missing data. There should be a mentioning, whether missing of data occurred at random.

Please add the description of lost to follow-up.

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6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

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Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

PONE-D-20-20926R1

Joint effect of alcohol drinking and tobacco smoking on all-cause mortality and premature death in China: a cohort study

PLOS ONE

Dear Dr. Yan,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

Please submit your revised manuscript by Jan 28 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file.

Please include the following items when submitting your revised manuscript:

• A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'.
• A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'.
• An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'.

If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter.

If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols

We look forward to receiving your revised manuscript.

Kind regards,

Muhammad Aziz Rahman, MBBS, MPH, CertGTC, GCHECTL, PhD

Academic Editor

PLOS ONE

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: I Don't Know

Reviewer #2: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

**********

5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

**********

6. Review Comments to the Author

Reviewer #1: This manuscript is much improved. My comments have been addressed. I would suggest a final edit, to ensure that all terminology matches throughout. For example sometimes cigarette smoking is used and sometimes tobacco smoking is used. I would make these consistent.

Reviewer #2: The authors addressed my comments. The paper will be improved if the tables may be made the figures for visualization. Please refer the Figure 2 and Figure 4 in the paper [https://doi.org/10.1007/s00125-020-05214-4 ]. I have no further concerns.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

Reviewer #2: No

[NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.]

While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step.

Joint effect of alcohol drinking and tobacco smoking on all-cause mortality and premature death in China: a cohort study

PONE-D-20-20926R2

Dear Dr. Yan,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Muhammad Aziz Rahman, MBBS, MPH, CertGTC, GCHECTL, PhD

Academic Editor

PLOS ONE