Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries.
Global burden of disease due to smokeless tobacco consumption in adults: analysis of data from 113 countries.
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DOI：
10.1186/s12916-015-0424-2
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发表时间：
2015-08-17
期刊：
影响因子：
9.3
通讯作者：
Sheikh A
中科院分区：
文献类型：
--
作者：
Siddiqi K;Shah S;Abbas SM;Vidyasagaran A;Jawad M;Dogar O;Sheikh A
世界上大多数国家都消费无烟烟草。鉴于其广泛使用和对相关风险的认识日益提高，有必要详细评估其对健康的影响。我们首次对成人无烟烟草消费造成的疾病负担作出全球估计。根据2010年全球疾病负担研究报告所报告的残疾调整生命年（DALYs）损失和死亡，估计了成人无烟烟草使用造成的负担。我们使用了比较风险评估方法，该方法评估了由于改变人群暴露于风险因素而导致的人群健康变化。根据具体国家无烟烟草消费流行率推断人口接触情况，并利用与之相关的特定疾病风险估计值（相对风险/优势比）估计人口健康的变化。通过系统地检索所有相关研究，获得了具体国家的患病率估计。通过进行基于流行病学研究的系统评价和荟萃分析来估计特定疾病的风险。我们发现了115个国家的成人无烟烟草消费数字和其中113个国家的估计疾病负担数字。我们的估计表明，2010年，无烟烟草使用导致因口腔癌、咽喉癌和食道癌而损失的残疾死亡数为170万，死亡人数为62,283人；根据基准的52个国家INTERHEART研究的数据，缺血性心脏病导致的残疾死亡数为470万，死亡人数为204,309人。其中85%以上的负担发生在东南亚。无烟烟草导致全球癌症发病率和死亡率很高，但这是可以预防的；与缺血性心脏病有关的估计需要更加谨慎地解释，但尽管如此，表明疾病的可能负担也很大。世界卫生组织需要考虑将无烟烟草管制纳入其《烟草控制框架公约》。本文的在线版本（doi:10.1186/s12916-015-0424-2）包含补充材料，可供授权用户使用。
Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults. The burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population’s exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies. We found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia. Smokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs to consider incorporating regulation of smokeless tobacco into its Framework Convention for Tobacco Control. The online version of this article (doi:10.1186/s12916-015-0424-2) contains supplementary material, which is available to authorized users.