Revista brasileira de epidemiologia = Brazilian journal of epidemiology最新文献

{"title":"Initiation of tobacco use during the pandemic: risk factors in the Brazilian context.","authors":"Deborah Carvalho Malta, Crizian Saar Gomes, Bárbara Aguiar Carrato, Giseli Nogueira Damacena, Paulo Roberto Borges de Souza Júnior, Wanessa da Silva Almeida, Célia Landmann Szwarcwald","doi":"10.1590/1980-549720260014","DOIUrl":"10.1590/1980-549720260014","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the incidence of tobacco use during the COVID-19 pandemic among Brazilian adults and to analyze the factors associated with initiation during this period.</p><p><strong>Methods: </strong>A cross-sectional study using data from the ConVid 2 - Pesquisa de Comportamento (ConVid 2 - Behavior Survey), conducted between July and December 2023 through virtual chain sampling. Prevalence of tobacco use before, during, and after the COVID-19 pandemic, as well as initiation during the pandemic, were assessed. Independent variables included sociodemographic characteristics, health conditions, mental health, and lifestyle factors. Prevalences and 95% confidence intervals (95%CI) were estimated, and factors associated with initiation were investigated using multivariable logistic regression.</p><p><strong>Results: </strong>The prevalence of smoking was 10.35% before the pandemic, 15.88% during (with an incidence of 5.5% of new smokers), and 12.2% in the post-pandemic period. Higher odds of smoking initiation during the pandemic were observed among individuals not living with a partner (OR=1.44; 95%CI 1.06-1.95), those who self-identified as non-white (OR=2.20; 95%CI 1.17-4.13), those reporting worsening feelings of sadness (OR=1.65; 95%CI 1.11-2.44), and those reporting increased alcohol consumption (OR=6.51; 95%CI 2.89-14.61). Lower odds were found among residents of the Southeast (OR=0.33; 95%CI 0.13-0.79) and Northeast (OR=0.25; 95%CI 0.11-0.57) regions.</p><p><strong>Conclusion: </strong>These findings highlight the need for public policies targeting more vulnerable populations.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260014"},"PeriodicalIF":2.0,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13123281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Linear regression in ecological studies involving space: methodology and an application example in public health.","authors":"Gleice Margarete de Souza Conceição, Patricia Marques Moralejo Bermudi, Raquel Gardini Sanches Palasio, Gerson Laurindo Barbosa, Camila Meireles Fernandes, Lidia Maria Reis Santana, Ligia Vizeu Barrozo, Daiane Leite da Roza, José Alberto Quintanilha, Francisco Chiaravalloti-Neto","doi":"10.1590/1980-549720260018","DOIUrl":"https://doi.org/10.1590/1980-549720260018","url":null,"abstract":"<p><p>Many health-related phenomena can be better understood when the geographic region in which they occur is taken into account. One of the most important aspects to consider in spatial study designs is the presence of autocorrelation in observations measured across space. If this spatial dependence is not properly modeled, the resulting statistics may be biased, compromising the validity of conclusions regarding the presence or absence of associations. Methodologies developed based on the linear regression model allow this dependence to be adequately accommodated, producing precise, robust, and unbiased estimates. With the aim of highlighting the applicability of spatial models and pointing out the necessary precautions in data analysis, this article describes, step by step, one of the most commonly used methodologies for spatial data analysis, as well as the measures to be taken to avoid modeling errors and distortion of results. The linear regression model is presented, along with procedures to evaluate model fit, the most commonly used measure to detect spatial dependence, and two autoregressive models frequently applied to model this dependence (SAR and SEM). An application example is provided using the GeoDa and R software.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260018"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sociodemographic determinants of health care in heart failure mortality in Mexico, 019 and 2023.","authors":"Julio Cesar Campuzano, Jorge Martin Rodríguez, Pablo Enrique Chaparro, Diana Carolina Urrego, Anaid Hernández","doi":"10.1590/1980-549720260019.2","DOIUrl":"https://doi.org/10.1590/1980-549720260019.2","url":null,"abstract":"<p><strong>Objective: </strong>To analyze sociodemographic determinants associated with medical care before death from heart failure (HF) in Mexico, comparing 2019 and 2023.</p><p><strong>Methods: </strong>A retrospective cross-sectional analytical study was conducted using national mortality records from the General Directorate of Epidemiology (DGE). HF deaths (ICD-10: I50.0-I50.9) from 2019 and 2023 were selected, representing pre- and post-pandemic (COVID-19) contexts. The variables included gender, age, education, marital status, health insurance coverage, area of residence, region, place of death, and year of occurrence. Multiple logistic regression was applied to estimate odds ratios (OR) with 95% confidence intervals (95% CI).</p><p><strong>Results: </strong>In the 2019-2023 period, 13,510 HF deaths were recorded (6,077 in 2019 and 7,433 in 2023). The probability of receiving medical care before death was 22% higher in 2023 compared to 2019 (OR 1.22; 95%CI 1.10-1.36). Medical care was more likely among individuals aged ≥80 years old, with higher educational levels, living in urban areas, and with health insurance coverage. Being male, lacking health coverage, and dying at home were associated with a lower probability of receiving medical care. The interaction between health insurance coverage and place of death revealed reduced access to medical care among individuals without social security who died at home.</p><p><strong>Conclusions: </strong>Substantial gaps in access to medical care persist, associated with structural and social inequalities. The post-pandemic recovery of coverage indicates a partial strengthening of the health system. Strengthening primary health care, expanding effective universal coverage, and developing strategies targeting vulnerable groups are recommended.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260019"},"PeriodicalIF":2.0,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities in the use of public oral health services among older adults in Brazil: a national population-based study, 2023.","authors":"Breno Marques de Mello, Debora Lana Alves Monteiro, Ayla Miranda de Oliveira, Bárbara Rachelli Farias Teixeira, Raissa Taynnar Albuquerque Lopes, Rênnis Oliveira da Silva, Yuri Wanderley Cavalcanti, Rafael Aiello Bomfim","doi":"10.1590/1980-549720260004.supl.1","DOIUrl":"https://doi.org/10.1590/1980-549720260004.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To analyze individual and contextual factors associated with the use of public dental services among Brazilian older adults, using data from SB Brasil 2023.</p><p><strong>Methods: </strong>A total of 9,745 older adults were included in this cross-sectional study. The outcome was the use of public oral health services versus private services. Analyses accounted for the complex sampling design and applied multilevel logistic regression with a random intercept at the municipal level, guided by Andersen's Behavioral Model. Independent variables included predisposing factors (race/skin color, sex, and level of education), enabling factors (per capita income and oral health coverage in Primary Health Care) and need factors (edentulism and perceived need for dental treatment and prostheses).</p><p><strong>Results: </strong>The weighted prevalence of public dental service use was 39.2% (95%CI 35.7-42.9). After adjustment, higher odds of using the public system were observed among Black (OR 1.97; 95%CI 1.60-2.40), mixed-race (OR 1.38; 95%CI 1.19-1.61), and Indigenous older adults (OR 5.16; 95%CI 2.01-13.21), as well as among those with edentulism (OR 1.44), perceived need for dental treatment (OR 1.26), and need for prostheses (OR 1.39). Living in municipalities with oral health coverage above 70% was associated with greater use of public services (OR 2.47; 95%CI 1.83-3.31). The proportion of variance attributable to the municipal level decreased from 28.3% in the null model to 16.7% in the final model.</p><p><strong>Conclusion: </strong>Public dental service use among older adults in Brazil is socially stratified and strongly associated with social vulnerability and oral health needs, highlighting the pro-equity role of the Brazilian Unified Health System.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260004supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of negative self-assessment of oral health and associated factors among adolescents from southeastern Brazil in the 2003 and 2023 Brazil Oral Health surveys.","authors":"Sheyla Omonte Neves, Giana Zarbato Longo, Karla Maria Damiano Teixeira","doi":"10.1590/1980-549720260001.supl.1","DOIUrl":"https://doi.org/10.1590/1980-549720260001.supl.1","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and factors associated with negative self-assessment of oral health among adolescents living in the Southeast region of Brazil.</p><p><strong>Methods: </strong>This is a cross-sectional study using data from the National Oral Health Survey of 2003 and 2023. Through examination and questionnaire, clinical, socioeconomic, and oral health perception data were obtained from 2981 individuals in 2003 and 919 in 2023. Descriptive, bivariate, and multivariate analyses were performed using Poisson regression with robust variance.</p><p><strong>Results: </strong>Negative self-assessment of oral health was observed in 43.9% (95% confidence interval - 95%CI 38.7-49.1) of participants in 2003 and 33.4% (95%CI 27.2-40.3) in 2023. In the multivariate analysis, the factors associated with worse self-assessment of oral health were: being 18 or 19 years old (prevalence ratio - PR 1.04; 95%CI 1.01-1.08 in 2003 and PR 1.27; 95%CI 1.00-1.63 in 2023), not owning a home (PR 1.16; 95%CI 1.01-1.32 in 2003), receiving government assistance (PR 1.40; 95%CI 1.11-1.77), feeling the need for treatment (PR 2.7; 95%CI 1.94-3.74 in 2003 and PR 3.0; 95%CI 1.58-5.70 in 2023), experiencing toothache (PR 1.67; 95%CI 1.38-2.04 in 2003 and PR 1.72; 95%CI 1.17-2.54 in 2023), having dental calculus (PR 1.22; 95%CI 1.04-1.43 in 2003 and PR 1.84; 95%CI 1.28-2.66 in 2023), having missing, decayed or filled teeth (PR 1.02; 95%CI 1.01-1.04 in 2003), loosing teeth due to cavities (PR 2.19; 95%CI 1.42-3.37 in 2023), and last visiting the dentist two to three years earlier (PR 1.89; 95%CI 1.39-2.56 in 2023).</p><p><strong>Conclusion: </strong>A high prevalence of negative self-assessment of oral health was observed among adolescents in the Southeast region, a finding associated with a multidimensional structure of variables.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29Suppl 1 Suppl 1","pages":"e260001supl1"},"PeriodicalIF":2.0,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of synthetic population to assess alcohol abuse in small areas.","authors":"Crizian Saar Gomes, Regina Tomie Ivata Bernal, Larissa Fortunato Araújo, Celso Renato França Júnior, Samuel Norberto Alves, Juliana Bottoni de Souza, Flora Vitória Serena Oliveira Baldi, Marcos André Gonçalves, Jussara Marques Almeida, Deborah Carvalho Malta","doi":"10.1590/1980-549720260013","DOIUrl":"10.1590/1980-549720260013","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the use of synthetic populations, generated by conditional generative adversarial networks (cGAN), to estimate abusive alcohol consumption in small areas of Belo Horizonte (MG).</p><p><strong>Methods: </strong>Data from the Vigitel survey from 2006 to 2018 were used. Sociodemographic and lifestyle variables were considered, and the synthetic records were assigned to nine vulnerability clusters.</p><p><strong>Results: </strong>The inclusion of synthetic data reduced standard errors and narrowed confidence intervals, especially in more vulnerable areas. Higher prevalence was observed in less vulnerable areas.</p><p><strong>Conclusions: </strong>The approach proved promising for overcoming representativeness limitations and enhancing risk factor monitoring, but it still depends on the quality of the original data, may introduce biases, and requires external validation and cautious use.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260013"},"PeriodicalIF":2.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors associated with false-negative results from the rapid molecular test for pulmonary tuberculosis in the state of São Paulo, Brazil.","authors":"Alexandre Tadashi Inomata Bruce, Mariana Gaspar Botelho Funari de Faria, Rubia Laine de Paula Andrade, Ricardo Alexandre Arcêncio, Ione Carvalho Pinto, Dulce Gomes, Esron Soares Carvalho Rocha, Manoel Eduardo de Aquino Tavares, Aline Aparecida Monroe","doi":"10.1590/1980-549720260012","DOIUrl":"10.1590/1980-549720260012","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the factors associated with the frequency of false negative results for the RMT-TB test for the diagnosis of pulmonary tuberculosis in the state of São Paulo.</p><p><strong>Methods: </strong>Cross-sectional study using pulmonary tuberculosis cases from the state of São Paulo reported in the TB-WEB system between 2014 and 2023. RMT-TB results were compared with sputum smear microscopy, sputum culture, and sensitivity testing. Subsequently, variables with p<0.05 in the statistical tests were included in the logistic regression.</p><p><strong>Results: </strong>There was a significant increase in the use of RMT-TB over the years, reaching 76% of cases in 2023. Analysis of the test accuracy revealed high agreement with sputum culture (82.6%) and the sensitivity test (98.4%), although it showed lower agreement with sputum smear microscopy (78.5%). The study identified factors associated with false-negative results on the RMT-TB, such as advanced age, female sex, HIV status, imprisoned, and a normal chest X-ray. Logistic regression confirmed that these factors increase the likelihood of false-negative results.</p><p><strong>Conclusion: </strong>The RMT-TB is an effective tool for diagnosing pulmonary tuberculosis, but the interpretation of results must consider each patient's specific risk factors, especially in high-risk populations. The study highlights the importance of combining the RMT-TB with other diagnostic methods and clinical evaluation to ensure accurate diagnosis and appropriate treatment.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260012"},"PeriodicalIF":2.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time series analysis (2015-2022): dengue risk scenario in Goiás, Brazil.","authors":"Ronaldo Rodrigues de Oliveira Junior, Ana Carolina Figueiredo Modesto, Leandro do Prado Assunção, Lindomar José Pena, Valéria Christina de Rezende Feres","doi":"10.1590/1980-549720260010","DOIUrl":"10.1590/1980-549720260010","url":null,"abstract":"<p><strong>Objective: </strong>To analyze confirmed cases of dengue in Goiás, Brazil between 2015 and 2022 and to estimate the risk of new outbreaks until 2026.</p><p><strong>Methods: </strong>A time series study using data from the Notifiable Diseases Information System (SINAN) was conducted. Monthly records of cases confirmed by laboratory or clinical-epidemiological criteria were included. The Seasonal Autoregressive Integrated Moving Average (SARIMA) model was applied using the R software (v.4.2.1). Stationarity, trend, seasonality, residual autocorrelation, and model fit were evaluated, with estimates obtained by maximum likelihood and 95% confidence intervals.</p><p><strong>Results: </strong>During the study period, 709,270 confirmed cases were recorded. Epidemics occurred cyclically every two years, with peaks in 2015 (101,261), 2016 (82,077), 2018 (70,794), 2019 (107,589), and 2022 (189,998), interspersed with years of lower incidence such as 2017 and the COVID-19 pandemic years (2020-2021). Serotype replacement was observed preceding major outbreaks. The SARIMA model showed good fit (Akaike Information Criterion - 1768.9; Bayesian Information Criterion - 1786.8) and predicted new peaks in 2025 (177,775 cases) and 2026 (224,100 cases).</p><p><strong>Conclusion: </strong>Dengue in Goiás displayed recurrent epidemic cycles, pointing to an increase in cases and reinforcing the need for integrated strategies based on prevention and control. The SARIMA model proved useful for surveillance and public health planning, although its accuracy may be influenced by external factors.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260010"},"PeriodicalIF":2.0,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, content validity, and reliability of an instrument to assess the commercialization of food and beverages in school canteens in Brazil.","authors":"Luiza Delazari Borges, Letícia Ferreira Tavares, Ariene Silva do Carmo, Letícia de Oliveira Cardoso, Raquel Canuto, Paulo César Pereira de Castro Junior, Sabrina Gomes Ferreira Clark, Luísa Arantes Vilela, Larissa Loures Mendes","doi":"10.1590/1980-549720260015","DOIUrl":"10.1590/1980-549720260015","url":null,"abstract":"<p><strong>Objectives: </strong>To develop, verify content validity, and evaluate the reliability of an instrument for assessing the commercialization of food and beverages in school canteens.</p><p><strong>Methods: </strong>The preliminary version of the instrument was developed following a literature review, identification of food environment dimensions, item development, and structuring of the instrument, which was divided into three sections: identification and characterization of canteens, commercialized foods, and food advertising. The instrument was evaluated by experts, and the content validity index was calculated for each item (deemed satisfactory if >0.80). Reliability was assessed in a sample of canteens using inter-rater and intra-rater tests. Values of kappa, prevalence-adjusted bias-adjusted kappa, and intraclass correlation coefficient were calculated.</p><p><strong>Results: </strong>The instrument included 945 items. The average content validity index score of the instrument, considering the evaluated aspects (relevance, clarity of item wording, and clarity of response options), was 0.95. Experts' suggestions were reviewed, and items were added, removed, or modified when appropriate. Regarding reliability, 95.2% of the total analyzed items showed excellent, very good, or good agreement (≥0.6).</p><p><strong>Conclusion: </strong>The instrument proved to be reliable for measuring the food environment in school canteens in the Brazilian context, showing satisfactory values for both content validity and reliability. Thus, the instrument contributes to advancing the assessment of food commercialization in canteens, an important aspect of the school food environment.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260015"},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of mortality attributable to passive smoking in the 27 Brazilian capitals, 2009-2021.","authors":"Bibiana Wanderlei Flores, Julia Rey-Brandariz, Paulo César Rodrigues Pinto Corrêa, Sofia Ravara, Agustín Montes Martinez, Mónica Pérez-Ríos","doi":"10.1590/1980-549720260017","DOIUrl":"10.1590/1980-549720260017","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the mortality attributable to passive smoking in the population aged 35 years old and older, by gender, in the 27 Brazilian state capitals, from 2009 to 2021.</p><p><strong>Methods: </strong>A prevalence-dependent method was used, based on the calculation of population attributable fractions (PAF). Deaths from diseases causally related to passive smoking were obtained from the Mortality Information System of the Brazilian Unified Health System (SIM/SUS); prevalence data were taken on SHS exposure were obtained from Vigitel surveys (2009-2021); and relative risks were obtained from a meta-analysis. Mortality attributable to passive smoking and mortality rates were estimated by capital city, year, gender, and cause of death. Trends in crude mortality rates attributable to passive smoking were analyzed using joinpoint regression models.</p><p><strong>Results: </strong>Passive smoking accounted for 64,913 deaths in all Brazilian state capitals between 2009 and 2021. Cardiovascular diseases were the main cause of death in both genders. The mortality rate attributed to passive smoking decreased from 33.1/100,000 deaths in 2009 to 15.4/100,000 deaths in 2021. This reduction was observed in all 27 Brazilian state capitals, both overall and by gender.</p><p><strong>Conclusion: </strong>Passive smoking was responsible for 1.4% of all deaths in Brazil during the period 2009-2021 and showed a favorable trend, with rates decreasing by half during the period.</p>","PeriodicalId":74697,"journal":{"name":"Revista brasileira de epidemiologia = Brazilian journal of epidemiology","volume":"29 ","pages":"e260017"},"PeriodicalIF":2.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}