Do not let the guard down on preventable behavioural risk factors.

Background: Preventable behavioural risk factors account for approximately one third of mortality, morbidity, and disability worldwide. This study aims to quantify the interest in behavioural risk factors within major medical journals in 2022 and to derive trends over the past 30 years in the entire medical literature.

Methods: We analysed the proportion of publications dealing with tobacco smoking, alcohol drinking, use of illicit drugs, excess body weight and physical activity among all the 1,128 articles published in JAMA, BMJ, Lancet and New England Journal of Medicine in 2022. A joinpoint analysis was conducted running in PubMed/MEDLINE specific search strings to evaluate trends over the last 30 years in the four journals and in the whole medical literature.

Results: In 2022, of all publications from the four considered medical journals, 2.8% dealt with tobacco smoking, 1.6% alcohol drinking, 1.1% use of illicit drugs, 3.8% excess body weight, 2.7% physical activity and 8.0% dealt with any behaviours. The joinpoint analysis on the whole medical literature showed that papers on modifiable risk factors significantly increased from 3.9% in 1993 to 6.2% in 2014 (annual percent change, APC: between +1.83% and +4.09%), and subsequently decreased between 2014 and 2019 (APC=-0.31%), with an acceleration thereafter (APC =-2.41% in 2019-2022).

Conclusions: For the first time we quantified the volume of medical research focused on preventable behavioural risk factors. This appears to be limited and declining over the last decade. Research on primary prevention should be a priority to face the emergence of associated non-communicable diseases globally.