Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.
Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.
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DOI：
10.1016/s0140-6736(21)01169-7
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发表时间：
2021-06-19
期刊：
影响因子：
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通讯作者：
GBD 2019 Tobacco Collaborators
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文献类型：
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作者：
GBD 2019 Tobacco Collaborators
结束全球烟草流行是全球健康领域的一项决定性挑战。需要及时、全面地估计吸烟的流行率和可归因的疾病负担，以指导国家和全球的烟草控制工作。作为全球疾病、伤害和风险因素负担研究的一部分，我们按年龄和性别估算了 1990 年至 2019 年 204 个国家和地区的吸烟流行率和可归因的疾病负担。我们根据 3625 项全国代表性调查对多项吸烟相关指标进行建模。我们完成了系统评价，并对 36 种因果关系的健康结果进行了贝叶斯元回归，以估计当前和以前吸烟者的非线性剂量反应风险曲线。我们使用直接估计方法来估计可归因的负担，提供比以前更全面的吸烟对健康影响的估计。 2019 年，全球有 1·140 亿（95% 不确定性区间 1·13–1·16）人是当前吸烟者，他们在 2019 年消费了 7·41 万亿（7·11–7·74）支卷烟当量的烟草。尽管自 1990 年以来，男性吸烟率显着下降（减少了 27·5% [26·5–28·5]）和 15 岁及以上女性（减少 37·7% [35·4–39·9]），人口增长导致吸烟者总数从 1990 年的 0·990 亿 (0·98–1·00) 大幅增加。2019 年全球范围内，吸烟导致 7·69 百万 (7·16–8·20) 人死亡和 2 亿人死亡 (185–214) 残疾调整生命年，是男性死亡的主要危险因素（男性死亡的 20·2% [19·3–21·1]）。因吸烟导致的 7·6900 万人死亡中，有 6·6800 万人 [86·9%] 是当前吸烟者。如果不采取干预措施，未来几十年，每年因吸烟导致的死亡人数将增加 7·6900 万人，残疾调整生命年将增加 2 亿人。各地区、各发展阶段的国家在减少吸烟流行率方面均取得了实质性进展，但烟草控制的实施仍存在巨大差距。各国有明确而紧迫的机会来通过强有力的、基于证据的政策，以加速减少吸烟率并为其公民带来巨大的健康益处。彭博慈善基金会和比尔及梅琳达·盖茨基金会。
Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Globally in 2019, 1·14 billion (95% uncertainty interval 1·13–1·16) individuals were current smokers, who consumed 7·41 trillion (7·11–7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5–28·5] reduction) and females (37·7% [35·4–39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98–1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16–8·20) deaths and 200 million (185–214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3–21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.