Impact of Smoking Reduction Scenarios on the Burden of Myocardial Infarction in the French Population Until 2035

IF 3.4 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Clinical Epidemiology Pub Date : 2024-09-07 DOI:10.2147/clep.s440815

Johann Kuhn, Valérie Olié, Clémence Grave, Yann Le Strat, Christophe Bonaldi, Pierre Joly

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引用次数: 0

Abstract

Aim: Myocardial infarction (MI) is a cardiovascular disease caused by necrosis of the myocardium, which places a heavy burden on patients. In France, the proportion of daily smokers remains high, reaching at 25.5% in 2020. We evaluated the impact of smoking reduction scenarios on the projection of MI prevalence, mean age of incident cases and number of MI prevented cases until 2035.
Methods and Results: The French government has introduced smoking cessation policies that have led to an annual decrease in smoking prevalence. Based on this annual decline, we implemented three scenarios (SC) simulating an annual decrease in the proportion of smokers aged over 35 (SC1: 1%, ie, natural evolution without intervention, SC2: 2%, SC3: 9.87%) and a fourth scenario (SC4) in which there is a complete discontinuation of smoking from 2024 onwards using MI hospitalization and demographic data, estimations for the proportion of daily smokers between 35 and 95 years and multi-state models. Between 2023 and 2035, MI prevalence increased from 3.18% to 4.23% in males and from 1.00% to 1.46% in females under SC1. MI prevalence was equal to 4.21%, 4.06%, and 3.82% in males and 1.45%, 1.40%, and 1.34% in females in 2035 according to SC2, SC3, and SC4, respectively. Compared with SC1, 0.68% MI cases would be prevented with SC2, 4.52% with SC3 and 10.34% with SC4, with almost half of cases being prevented before 65 years of age. The increase in the mean age of MI incident cases ranged from 3 to 4 years among males and from 1 to 2 years among females.
Conclusion: While reducing tobacco use could substantially reduce the number of MI cases prevented, its prevalence would continue to increase due to the ageing population. An integrated prevention strategy that includes the leading cardiovascular risk factors should more efficiently reduce the future burden of MI.

Keywords: myocardial infarction, prevalence, burden, projection, tobacco control, smoking prevalence

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2035 年前减少吸烟方案对法国人口心肌梗死负担的影响

目的：心肌梗塞（MI）是一种由心肌坏死引起的心血管疾病，给患者带来沉重负担。在法国，每日吸烟者的比例仍然很高，2020 年将达到 25.5%。我们评估了减烟方案对 2035 年前心肌梗死发病率、发病病例平均年龄和心肌梗死预防病例数预测的影响：法国政府推出的戒烟政策导致吸烟率逐年下降。根据这一逐年下降的趋势，我们使用心肌梗死住院和人口数据、35岁至95岁每日吸烟者比例估算值以及多状态模型，模拟了35岁以上吸烟者比例逐年下降的三种情景（SC1：1%，即无干预的自然演变；SC2：2%；SC3：9.87%）和第四种情景（SC4），即从2024年起完全停止吸烟。在 2023 年至 2035 年期间，SC1 的男性心肌梗死患病率从 3.18% 上升至 4.23%，女性从 1.00% 上升至 1.46%。根据 SC2、SC3 和 SC4，2035 年男性心肌梗死发病率分别为 4.21%、4.06% 和 3.82%，女性分别为 1.45%、1.40% 和 1.34%。与 SC1 相比，SC2 可预防 0.68% 的心肌梗死病例，SC3 可预防 4.52% 的心肌梗死病例，SC4 可预防 10.34% 的心肌梗死病例，其中近一半的病例可在 65 岁之前预防。男性心肌梗死病例的平均年龄增加了 3 至 4 岁，女性增加了 1 至 2 岁：结论：虽然减少烟草使用可大幅减少心肌梗死的发病率，但由于人口老龄化，心肌梗死的发病率仍将继续上升。包括主要心血管风险因素在内的综合预防策略应能更有效地降低心肌梗死的未来负担。关键词：心肌梗死；流行率；负担；预测；烟草控制；吸烟率

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来源期刊

Clinical Epidemiology Medicine-Epidemiology

CiteScore

6.30

自引率

5.10%

发文量

169

审稿时长

16 weeks

期刊介绍： Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment. Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews. Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews. When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes. The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.