Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015

Reitsma, Marissa B. and Fullman, Nancy and Ng, Marie and Salama, Joseph S. and Abajobir, Amanuel and Abate, Kalkidan Hassen and Abbafati, Cristiana and Abera, Semaw Ferede and Abraham, Biju and Abyu, Gebre Yitayih and Adebiyi, Akindele Olupelumi and Al-Aly, Ziyad and Aleman, Alicia V. and Ali, Raghib and Al Alkerwi, Ala'a and Allebeck, Peter and Al-Raddadi, Rajaa Mohammad and Amare, Azmeraw T. and Amberbir, Alemayehu and Ammar, Walid and Amrock, Stephen Marc and Antonio, Carl Abelardo T. and Asayesh, Hamid and Atnafu, Niguse Tadela and Azzopardi, Peter and Banerjee, Amitava and Barac, Aleksandra and Barrientos-Gutierrez, Tonatiuh and Basto-Abreu, Ana Cristina and Bazargan-Hejazi, Shahrzad and Bedi, Neeraj and Bell, Brent and Bello, Aminu K. and Bensenor, Isabela M. and Beyene, Addisu Shunu and Bhala, Neeraj and Biryukov, Stan and Bolt, Kaylin and Brenner, Hermann and Butt, Zahid and Cavalleri, Fiorella and Cercy, Kelly and Chen, Honglei and Christopher, Devasahayam Jesudas and Ciobanu, Liliana G. and Colistro, Valentina and Colomar, Mercedes and Cornaby, Leslie and Dai, Xiaochen and Damtew, Solomon Abrha and Dandona, Lalit and Dandona, Rakhi and Dansereau, Emily and Davletov, Kairat and Dayama, Anand and Degfie, Tizta Tilahun and Deribew, Amare and Dharmaratne, Samath D. and Dimtsu, Balem Demtsu and Doyle, Kerrie E. and Endries, Aman Yesuf and Ermakov, Sergey Petrovich and Estep, Kara and Faraon, Emerito Jose Aquino and Farzadfar, Farshad and Feigin, Valery L. and Feigl, Andrea B. and Fischer, Florian and Friedman, Joseph and G/hiwot, Tsegaye Tewelde and Gall, Seana L. and Gao, Wayne and Gillum, Richard F. and Gold, Audra L. and Gopalani, Sameer Vali and Gotay, Carolyn C and Gupta, Rahul and Gupta, Rajeev and Gupta, Vipin and Hamadeh, Randah Ribhi and Hankey, Graeme and Harb, Hilda L. and Hay, Simon I. and Horino, Masako and Horita, Nobuyuki and Hosgood, H. Dean and Husseini, Abdullatif and Ileanu, Bogdan Vasile and Islami, Farhad and Jiang, Guohong and Jiang, Ying and Jonas, Jost B. and Kabir, Zubair and Kamal, Ritul and Kasaeian, Amir and Kesavachandran, Chandrasekharan Nair and Khader, Yousef S. and Khalil, Ibrahim and Khang, Young-Ho and Khera, Sahil and Khubchandani, Jagdish and Kim, Daniel and Kim, Yun Jin and Kimokoti, Ruth W. and Kinfu, Yohannes and Knibbs, Luke D. and Kokubo, Yoshihiro and Kolte, Dhaval and Kopec, Jacek and Kosen, Soewarta and Kotsakis, Georgios A. and Koul, Parvaiz A. and Koyanagi, Ai and Krohn, Kristopher J. and Krueger, Hans and Defo, Barthelemy Kuate and Bicer, Burcu Kucuk and Kulkarni, Chanda and Kumar, G. Anil and Leasher, Janet L. and Lee, Alexander and Leinsalu, Mall and Li, Tong and Linn, Shai and Liu, Patrick and Liu, Shiwei and Lo, Loon-Tzian and Lopez, Alan D. and Ma, Stefan and El Razek, Hassan Magdy Abd and Majeed, Azeem and Malekzadeh, Reza and Malta, Deborah Carvalho and Manamo, Wondimu Ayele and Martinez-Raga, Jose and Mekonnen, Alemayehu Berhane and Mendoza, Walter and Miller, Ted R. and Mohammad, Karzan Abdulmuhsin and Morawska, Lidia and Musa, Kamarul Imran and Nagel, Gabriele and Neupane, Sudan Prasad and Nguyen, Quyen and Nguyen, Grant and Oh, In-Hwan and Oyekale, Abayomi Samuel and PA, Mahesh and Pana, Adrian and Park, Eun-Kee and Patil, Snehal T. and Patton, George C. and Pedro, Joao and Qorbani, Mostafa and Rafay, Anwar and Rahman, Mahfuzar and Rai, Rajesh Kumar and Ram, Usha and Ranabhat, Chhabi Lal and Refaat, Amany H. and Reinig, Nickolas and Roba, Hirbo Shore and Rodriguez, Alina and Roman, Yesenia and Roth, Gregory and Roy, Ambuj and Sagar, Rajesh and Salomon, Joshua and Sanabria, Juan and de Souza Santos, Itamar and Sartorius, Benn and Satpathy, Maheswar and Sawhney, Monika and Sawyer, Susan and Saylan, Mete and Schaub, Michael P. and Schluger, Neil and Schutte, Aletta Elisabeth and Sepanlou, Sadaf G. and Serdar, Berrin and Shaikh, Masood Ali and She, Jun and Shin, Min-Jeong and Shiri, Rahman and Shishani, Kawkab and Shiue, Ivy and Sigfusdottir, Inga Dora and Silverberg, Jonathan I. and Singh, Jasvinder and Singh, Virendra and Slepak, Erica Leigh and Soneji, Samir and Soriano, Joan B. and Soshnikov, Sergey and Sreeramareddy, Chandrashekhar T and Stein, Dan J. and Stranges, Saverio and Subart, Michelle L. and Swaminathan, Soumya and Szoeke, Cassandra E. I. and Tefera, Worku Mekonnen and Topor-Madry, Roman and Tran, Bach and Tsilimparis, Nikolaos and Tymeson, Hayley and Ukwaja, Kingsley Nnanna and Updike, Rachel and Uthman, Olalekan A. and Violante, Francesco Saverio and Vladimirov, Sergey K. and Vlassov, Vasiliy and Vollset, Stein Emil and Vos, Theo and Weiderpass, Elisabete and Wen, Chi-Pan and Werdecker, Andrea and Wilson, Shelley and Wubshet, Mamo and Xiao, Lin and Yakob, Bereket and Yano, Yuichiro and Ye, Penpeng and Yonemoto, Naohiro and Yoon, Seok-Jun and Younis, Mustafa Z. and Yu, Chuanhua and Zaidi, Zoubida and El Sayed Zaki, Maysaa and Zhang, Anthony Lin and Zipkin, Ben and Murray, Christopher J. L. and Forouzanfar, Mohammad H. and Gakidou, Emmanuela (2017) Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015. The Lancet, 389 (10082). pp. 1885-1906. ISSN 0140-6736

Full content URL:

Smoking prevalence and attributable disease burden in 195 countries and territories, 1990–2015: a systematic analysis from the Global Burden of Disease Study 2015
27623 gbd15_tobacco_manuscript_text_revised.pdf
27623 gbd15_tobacco_manuscript_tables_revised.pdf
27623 GBD_smoking prevalence-disease burden_Lancet 2017.pdf - Whole Document
Available under License Creative Commons Attribution 4.0 International.

27623 gbd15_tobacco_manuscript_text_revised.pdf - Whole Document
Available under License Creative Commons Attribution 4.0 International.

27623 gbd15_tobacco_manuscript_tables_revised.pdf - Supplemental Material
Available under License Creative Commons Attribution 4.0 International.

Item Type:Article
Item Status:Live Archive


Background The scale-up of tobacco control, especially after the adoption of the Framework Convention for Tobacco
Control, is a major public health success story. Nonetheless, smoking remains a leading risk for early death and
disability worldwide, and therefore continues to require sustained political commitment. The Global Burden of
Diseases, Injuries, and Risk Factors Study (GBD) offers a robust platform through which global, regional, and
national progress toward achieving smoking-related targets can be assessed.
Methods We synthesised 2818 data sources with spatiotemporal Gaussian process regression and produced estimates
of daily smoking prevalence by sex, age group, and year for 195 countries and territories from 1990 to 2015. We analysed
38 risk-outcome pairs to generate estimates of smoking-attributable mortality and disease burden, as measured by
disability-adjusted life-years (DALYs). We then performed a cohort analysis of smoking prevalence by birth-year cohort
to better understand temporal age patterns in smoking. We also did a decomposition analysis, in which we parsed out
changes in all-cause smoking-attributable DALYs due to changes in population growth, population ageing, smoking
prevalence, and risk-deleted DALY rates. Finally, we explored results by level of development using the
Socio-demographic Index (SDI).
Findings Worldwide, the age-standardised prevalence of daily smoking was 25·0% (95% uncertainty interval [UI]
24·2–25·7) for men and 5·4% (5·1–5·7) for women, representing 28·4% (25·8–31·1) and 34·4% (29·4–38·6)
reductions, respectively, since 1990. A greater percentage of countries and territories achieved significant annualised
rates of decline in smoking prevalence from 1990 to 2005 than in between 2005 and 2015; however, only four countries
had significant annualised increases in smoking prevalence between 2005 and 2015 (Congo [Brazzaville] and
Azerbaijan for men and Kuwait and Timor-Leste for women). In 2015, 11·5% of global deaths (6·4 million [95% UI
5·7–7·0 million]) were attributable to smoking worldwide, of which 52·2% took place in four countries (China, India,
the USA, and Russia). Smoking was ranked among the five leading risk factors by DALYs in 109 countries and
territories in 2015, rising from 88 geographies in 1990. In terms of birth cohorts, male smoking prevalence followed
similar age patterns across levels of SDI, whereas much more heterogeneity was found in age patterns for female
smokers by level of development. While smoking prevalence and risk-deleted DALY rates mostly decreased by sex and
SDI quintile, population growth, population ageing, or a combination of both, drove rises in overall smokingattributable
DALYs in low-SDI to middle-SDI geographies between 2005 and 2015.
Interpretation The pace of progress in reducing smoking prevalence has been heterogeneous across geographies,
development status, and sex, and as highlighted by more recent trends, maintaining past rates of decline should not
be taken for granted, especially in women and in low-SDI to middle-SDI countries. Beyond the effect of the tobacco
industry and societal mores, a crucial challenge facing tobacco control initiatives is that demographic forces are
poised to heighten smoking’s global toll, unless progress in preventing initiation and promoting cessation can be
substantially accelerated. Greater success in tobacco control is possible but requires effective, comprehensive, and
adequately implemented and enforced policies, which might in turn require global and national levels of political
commitment beyond what has been achieved during the past 25 years.

Keywords:Global Burden of Disease, Smoking, Epidemiology
Subjects:B Subjects allied to Medicine > B990 Subjects Allied to Medicine not elsewhere classified
L Social studies > L510 Health & Welfare
Divisions:College of Social Science > School of Psychology
ID Code:27623
Deposited On:02 Jun 2017 14:23

Repository Staff Only: item control page