Estimates of global mortality attributable to smoking in 2000
Estimates of global mortality attributable to smoking in 2000
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DOI：
10.1016/s0140-6736(03)14338-3
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发表时间：
2003-09-13
期刊：
影响因子：
168.9
通讯作者：
Lopez, AD
中科院分区：
文献类型：
--
作者：
Ezzati, M;Lopez, AD
吸烟是导致多种疾病的危险因素，在许多发展中国家，吸烟的风险一直在增加。我们的目的是估计2000年由吸烟引起的全球和区域死亡率，包括不确定性分析。方法采用Peto等人的方法，将肺癌死亡率作为累积吸烟风险的间接标志。从不吸烟的肺癌死亡率是根据家庭使用通风不良的煤炭来估计的。相对危险度取自美国癌症协会癌症预防研究II期，以及Liu及其同事在中国的回顾性比例死亡率分析。校正了混淆和外推到其他地区的相对风险。结果我们估计，2000年，全世界有483万人（不确定范围394 - 593）过早死亡可归因于吸烟；发展中国家有2.41（180 - 315）万人，工业化国家有2.43（213 - 278）万人。其中384万是男性。吸烟导致的主要死亡原因是心血管疾病（169万人死亡）、慢性阻塞性肺病（97万人死亡）和肺癌（85万人死亡）。吸烟是2000年全球死亡的一个重要原因。鉴于预计发展中国家的人口和流行病学转变以及目前的吸烟模式，除非实施有效的干预措施和政策，减少发展中国家男子吸烟人数和防止妇女吸烟人数增加，否则吸烟造成的健康损失将会更大。
Background Smoking is a risk factor for several diseases and has been increasing in many developing countries. Our aim was to estimate global and regional mortality in 2000 caused by smoking, including an analysis of uncertainty.Methods Following the methods of Peto and colleagues, we used lung-cancer mortality as an indirect marker for accumulated smoking risk. Never-smoker lung-cancer mortality was estimated based on the household use of coal with poor ventilation. Relative risks were taken from the American Cancer Society Cancer Prevention Study, phase II, and the retrospective proportional mortality analysis of Liu and colleagues in China. Relative risks were corrected for confounding and extrapolation to other regions.Results We estimated that in 2000, 4.83 (uncertainty range 3.94-5.93) million premature deaths in the world were attributable to smoking; 2.41 (1.80-3.15) million in developing countries and 2.43 (2.13-2.78) million in industrialised countries. 3.84 million of these deaths were in men. The leading causes of death from smoking were cardiovascular diseases (1.69 million deaths), chronic obstructive pulmonary disease (0.97 million deaths), and lung cancer (0.85 million deaths).Interpretation Smoking was an important cause of global mortality in 2000. In view of the expected demographic and epidemiological transitions and current smoking patterns in the developing world, the health loss due to smoking will grow even larger unless effective interventions and policies that reduce smoking among men and prevent increases among women in developing countries are implemented.