MORTALITY FROM TOBACCO IN DEVELOPED-COUNTRIES - INDIRECT ESTIMATION FROM NATIONAL VITAL-STATISTICS
MORTALITY FROM TOBACCO IN DEVELOPED-COUNTRIES - INDIRECT ESTIMATION FROM NATIONAL VITAL-STATISTICS
复制标题
DOI：
10.1016/0140-6736(92)91600-d
复制
发表时间：
1992-05-23
期刊：
影响因子：
168.9
通讯作者：
HEATH, C
中科院分区：
文献类型：
--
作者：
PETO, R;LOPEZ, AD;HEATH, C
长期吸烟导致的其他疾病死亡人数甚至比肺癌还要多。在发达国家，按年龄性别区分的肺癌绝对发病率可用于表明吸烟造成的死亡的大致比例，这些死亡不仅来自肺癌本身，还间接来自血管疾病和各种其他类别的疾病。因此，即使没有关于吸烟史的直接资料，也可以仅根据所有主要发达国家大约1985年（以及1975年和1995年的外推）的疾病死亡率统计数字，大致估计全国烟草死亡率。肺癌的绝对过量和其他疾病的比例过量之间的关系只能是近似的，为了不高估烟草的影响，它被认为只有最近一项对100万美国人吸烟与死亡的大型前瞻性研究所表明的一半。这些方法的应用表明，仅在发达国家，每年因吸烟死亡的人数在1965年约为90万，1975年为130万，1985年为170万，1995年为210万（因此在1990- 1999年十年约为2100万：欧共体500 - 600万，美国500 - 600万，前苏联500万，东欧和其他欧洲300万，其他地区200万，[即澳大利亚、加拿大、日本和新西兰]）。其中一半以上的死亡将发生在35-69岁之间：在20世纪90年代，烟草将在发达国家造成约30%的35-69岁之间死亡（使其成为过早死亡的最大单一原因），加上约14%的老年人死亡。然而，那些在老年时死亡的人平均已经快80岁了，而且可能很快就会死去，但那些在35-69岁时死于烟草的人平均损失了大约23年的寿命。目前，发达国家所有死亡人数中有不到20%归因于烟草，但这一比例仍在上升，这表明，按照目前的吸烟模式，现在生活在发达国家的人中，有超过20%的人最终将死于烟草（即，在目前不到2.5亿的总人口中，约有2.5亿人）。
Prolonged cigarette smoking causes even more deaths from other diseases than from lung cancer. In developed countries, the absolute age-sex-specific lung cancer rates can be used to indicate the approximate proportions due to tobacco of deaths not only from lung cancer itself but also, indirectly, from vascular disease and from various other categories of disease. Even in the absence of direct information on smoking histories, therefore, national mortality from tobacco can be estimated approximately just from the disease mortality statistics that are available from all major developed countries for about 1985 (and for 1975 and so, by extrapolation, for 1995). The relation between the absolute excess of lung cancer and the proportional excess of other diseases can only be approximate, and so as not to overestimate the effects of tobacco it has been taken to be only half that suggested by a recent large prospective study of smoking and death among one million Americans.Application of such methods indicates that in developed countries alone, annual deaths from smoking number about 0.9 million in 1965, 1.3 million in 1975, 1.7 million in 1985, and 2.1 million in 1995 (and hence about 21 million in the decade 1990-99: 5-6 million European Community, 5-6 million USA, 5 million former USSR, 3 million Eastern and other Europe, and 2 million elsewhere, [ie, Australia, Canada, Japan, and New Zealand]). More than half these deaths will be at 35-69 years of age: during the 1990s tobacco will in developed countries cause about 30% of all deaths at 35-69 (making it the largest single cause of premature death) plus about 14% of all at older ages. Those killed at older ages are on average already almost 80 years old, however, and might have died soon anyway, but those killed by tobacco at 35-69 lose an average of about 23 years of life.At present just under 20% of all deaths in developed countries are attributed to tobacco, but this percentage is still rising, suggesting that on current smoking patterns just over 20% of those now living in developed countries will eventually be killed by tobacco (ie, about a quarter of a billion, out of a current total population of just under one and a quarter billion).