Tuberculosis burden attributable to smoking in China 1990-2021 and projections to 2040: A secondary analysis of GBD 2021 data.

IF 2.4 4区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Tobacco Induced Diseases Pub Date : 2026-07-20 eCollection Date: 2026-01-01 DOI:10.18332/tid/215180

Feng Zhao, Tingyong Yan

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引用次数: 0

Abstract

Introduction: Smoking is a well-established modifiable risk factor for tuberculosis (TB). However, the evolving smoking-attributable TB burden in China remains to be fully characterized. The objective was to examine temporal trends in the smoking-attributable TB burden in China from 1990 to 2021.

Methods: A secondary analysis was conducted on the 2021 Global Burden of Disease Study data. Data on the number of deaths and disability adjusted life years (DALYs) due to smoking-attributable TB, as well as age-standardized rates, were extracted for the overall Chinese population, males, and females from 1990 to 2021. Joinpoint regression and age-period-cohort analyses described 32-year trends. A Bayesian age-period-cohort (BAPC) model was used to forecast the TB burden from 2022 to 2040. Drivers behind the burden trends were investigated through a decomposition analysis.

Results: Between 1990 and 2021, TB deaths, DALYs, age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) showed significant reductions, with the ASMR and ASDR declining from 5.10/100000 (95% UI: 3.64-6.73) and 158.48/100000 (95% UI: 114.49-203.94) in 1990 to 0.52/100000 (95% UI: 0.37-0.76) and 19.15/100000 (95% UI: 13.85-26.70) in 2021, respectively. Declines in ASMR (-95.26% vs -89.35%) and ASDR (-93.69% vs -87.35%) were larger in females than in males. Age-period-cohort analyses revealed that mortality and DALY rates peaked at ages 30-34 years and then declined. Male mortality increased slightly at ages 65-69 years. Both period and cohort effects demonstrated consistent downward trends. BAPC projections indicated that after 2022, deaths and DALYs would decline initially but rise again, whereas ASMR and ASDR would continue to fall.

Conclusions: The smoking-attributable TB burden in China exhibits significant age- and sex-specific patterns. Despite overall attenuation, projected rebounds in deaths by 2040 call for sustained public health interventions.

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1990-2021年中国吸烟导致的结核病负担及2040年预测：对2021年GBD数据的二次分析

吸烟是公认的可改变的结核病危险因素。然而，中国吸烟导致的结核病负担的演变仍有待充分描述。目的是研究1990年至2021年中国吸烟导致的结核病负担的时间趋势。方法：对2021年全球疾病负担研究数据进行二次分析。从1990年至2021年，提取了中国总人口、男性和女性因吸烟导致的结核病死亡和残疾调整生命年（DALYs）数量以及年龄标准化率的数据。结合点回归和年龄期队列分析描述了32年的趋势。采用贝叶斯年龄-时期-队列（BAPC）模型预测2022 - 2040年结核病负担。通过分解分析调查了负担趋势背后的驱动因素。结果：1990 - 2021年，结核病死亡、DALYs、年龄标准化死亡率（ASMR）和年龄标准化DALY率（ASDR）均有显著下降，ASMR和ASDR分别从1990年的5.10/10万（95% UI: 3.64 ~ 6.73）和158.48/10万（95% UI: 114.49 ~ 203.94）下降到2021年的0.52/10万（95% UI: 0.37 ~ 0.76）和19.15/10万（95% UI: 13.85 ~ 26.70）。女性ASMR （-95.26% vs -89.35%）和ASDR （-93.69% vs -87.35%）的下降幅度大于男性。年龄期队列分析显示，死亡率和DALY率在30-34岁达到峰值，然后下降。65-69岁男性死亡率略有上升。时期和群体效应都显示出一致的下降趋势。BAPC的预测表明，2022年后，死亡人数和伤残调整生命年将开始下降，但再次上升，而ASMR和ASDR将继续下降。结论：中国吸烟导致的结核病负担具有明显的年龄和性别特征。尽管总体上有所下降，但预计到2040年死亡人数将出现反弹，因此需要采取持续的公共卫生干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Tobacco Induced Diseases SUBSTANCE ABUSE-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

5.30

自引率

5.40%

发文量

审稿时长

12 weeks

期刊介绍： Tobacco Induced Diseases encompasses all aspects of research related to the prevention and control of tobacco use at a global level. Preventing diseases attributable to tobacco is only one aspect of the journal, whose overall scope is to provide a forum for the publication of research articles that can contribute to reducing the burden of tobacco induced diseases globally. To address this epidemic we believe that there must be an avenue for the publication of research/policy activities on tobacco control initiatives that may be very important at a regional and national level. This approach provides a very important "hands on" service to the tobacco control community at a global scale - as common problems have common solutions. Hence, we see ourselves as "connectors" within this global community. The journal hence encourages the submission of articles from all medical, biological and psychosocial disciplines, ranging from medical and dental clinicians, through health professionals to basic biomedical and clinical scientists.