Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Population Health Metrics Pub Date : 2020-09-30 DOI:10.1186/s12963-020-00215-2

Deborah Carvalho Malta, Luisa Sorio Flor, Ísis Eloah Machado, Mariana Santos Felisbino-Mendes, Luisa Campos Caldeira Brant, Antonio Luiz Pinho Ribeiro, Renato Azeredo Teixeira, Eduardo Marques Macário, Marissa B Reitsma, Scott Glenn, Mohsen Naghavi, Emmanuela Gakidou

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引用次数: 25

Abstract

Background: The present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District.

Methods: Prevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017.

Results: Between 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI - 61.2, - 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms.

Conclusions: Brazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development.

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1990年和2017年巴西和联邦单位吸烟患病率和死亡率负担趋势。

背景:本研究旨在分析巴西、26个州和联邦区2017年全球疾病负担研究得出的吸烟率和吸烟导致的死亡率估计值。方法:采用时空高斯过程回归分析1990 - 2017年按性别和年龄划分的吸烟者患病率。计算不同风险-结局对的人群归因分数，以估算吸烟归因死亡率。为了更好地了解吸烟的时间年龄模式，对出生-年份队列进行了吸烟流行率的队列分析。使用社会人口指数(SDI)，描述和分析了各州的发展情况。最后，进行了分解分析，以评估1990年至2017年期间不同因素对吸烟死亡人数变化的贡献。结果:1990年至2017年，巴西人群(≥20岁)吸烟率从35.3%下降到11.3%。这种下降趋势在男女和所有州都可以看到，在年轻人群中，暴露于这种风险因素的人数明显减少。1990年至2017年期间，吸烟导致的死亡率下降了57.8% (95% UI - 61.2， - 54.1)。总体而言，在SDI较高的州，观察到更大的下降(Pearson相关系数0.637;P < 0.01)。在巴西，吸烟仍然是造成大量死亡的原因，特别是由于心血管疾病和肿瘤。结论:巴西采取了一套管制措施并实施了反烟草政策，加上社会经济条件的改善，促成了本研究的结果。为了实现《2030年联合国可持续发展议程》范围内确立的目标，需要实施其他监管措施，以促进减少吸烟。

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

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.