Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017

Population Health Metrics

Eduardo Marques Macário¹  Luisa Campos Caldeira Brant²  Antonio Luiz Pinho Ribeiro²  Deborah Carvalho Malta³  Mariana Santos Felisbino-Mendes³  Marissa B. Reitsma⁴  Scott Glenn⁴  Emmanuela Gakidou⁴  Luisa Sorio Flor⁴  Mohsen Naghavi⁴  Ísis Eloah Machado⁵  Renato Azeredo Teixeira⁶ 

[1] Department of Health Analysis and Surveillance of Noncommunicable Diseases, Secretariat of Health Surveillance, Ministry of Health, Brasília, DF, Brazil;Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil;Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, n.° 190, Santa Efigênia, CEP: 30130-100, Belo Horizonte, MG, Brazil;Postgraduate Program in Nursing, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil;Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA;Postgraduate Program in Nursing, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil;Department of Family Medicine, Mental and Public Health, School of Medicine, Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil;Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil;

关键词: Global burden of disease;    Quality-adjusted life years;    Risk factors;    Smoking;    Tobacco use;   

DOI  :  10.1186/s12963-020-00215-2

来源: Springer

【 摘 要 】

BackgroundThe present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District.MethodsPrevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017.ResultsBetween 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI − 61.2, − 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms.ConclusionsBrazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development.

【 授权许可】

CC BY