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., Fullman, Nancy, Ng, Marie, Salama, Joseph S., Abajobir, Amanuel, Abate, Kalkidan Hassen, Abbafati, Cristiana, Abera, Semaw Ferede, Abraham, Biju, Abyu, Gebre Yitayih, Adebiyi, Akindele Olupelumi, Al-Aly, Ziyad, Aleman, Alicia V., Ali, Raghib, Al Alkerwi, Ala'a, Allebeck, Peter, Al-Raddadi, Rajaa Mohammad, Amare, Azmeraw T., Amberbir, Alemayehu, Ammar, Walid, Amrock, Stephen Marc, Antonio, Carl Abelardo T., Asayesh, Hamid, Atnafu, Niguse Tadela, Azzopardi, Peter, Banerjee, Amitava, Barac, Aleksandra, Barrientos-Gutierrez, Tonatiuh, Basto-Abreu, Ana Cristina, Bazargan-Hejazi, Shahrzad, Bedi, Neeraj, Bell, Brent, Bello, Aminu K., Bensenor, Isabela M., Beyene, Addisu Shunu, Bhala, Neeraj, Biryukov, Stan, Bolt, Kaylin, Brenner, Hermann, Butt, Zahid, Cavalleri, Fiorella, Cercy, Kelly, Chen, Honglei, Christopher, Devasahayam Jesudas, Ciobanu, Liliana G., Colistro, Valentina, Colomar, Mercedes, Cornaby, Leslie, Dai, Xiaochen, Damtew, Solomon Abrha, Dandona, Lalit, Dandona, Rakhi, Dansereau, Emily, Davletov, Kairat, Dayama, Anand, Degfie, Tizta Tilahun, Deribew, Amare, Dharmaratne, Samath D., Dimtsu, Balem Demtsu, Doyle, Kerrie E., Endries, Aman Yesuf, Ermakov, Sergey Petrovich, Estep, Kara, Faraon, Emerito Jose Aquino, Farzadfar, Farshad, Feigin, Valery L., Feigl, Andrea B., Fischer, Florian, Friedman, Joseph, G/hiwot, Tsegaye Tewelde, Gall, Seana L., Gao, Wayne, Gillum, Richard F., Gold, Audra L., Gopalani, Sameer Vali, Gotay, Carolyn C, Gupta, Rahul, Gupta, Rajeev, Gupta, Vipin, Hamadeh, Randah Ribhi, Hankey, Graeme, Harb, Hilda L., Hay, Simon I., Horino, Masako, Horita, Nobuyuki, Hosgood, H. Dean, Husseini, Abdullatif, Ileanu, Bogdan Vasile, Islami, Farhad, Jiang, Guohong, Jiang, Ying, Jonas, Jost B., Kabir, Zubair, Kamal, Ritul, Kasaeian, Amir, Kesavachandran, Chandrasekharan Nair, Khader, Yousef S., Khalil, Ibrahim, Khang, Young-Ho, Khera, Sahil, Khubchandani, Jagdish, Kim, Daniel, Kim, Yun Jin, Kimokoti, Ruth W., Kinfu, Yohannes, Knibbs, Luke D., Kokubo, Yoshihiro, Kolte, Dhaval, Kopec, Jacek, Kosen, Soewarta, Kotsakis, Georgios A., Koul, Parvaiz A., Koyanagi, Ai, Krohn, Kristopher J., Krueger, Hans, Defo, Barthelemy Kuate, Bicer, Burcu Kucuk, Kulkarni, Chanda, Kumar, G. Anil, Leasher, Janet L., Lee, Alexander, Leinsalu, Mall, Li, Tong, Linn, Shai, Liu, Patrick, Liu, Shiwei, Lo, Loon-Tzian, Lopez, Alan D., Ma, Stefan, El Razek, Hassan Magdy Abd, Majeed, Azeem, Malekzadeh, Reza, Malta, Deborah Carvalho, Manamo, Wondimu Ayele, Martinez-Raga, Jose, Mekonnen, Alemayehu Berhane, Mendoza, Walter, Miller, Ted R., Mohammad, Karzan Abdulmuhsin, Morawska, Lidia, Musa, Kamarul Imran, Nagel, Gabriele, Neupane, Sudan Prasad, Nguyen, Quyen, Nguyen, Grant, Oh, In-Hwan, Oyekale, Abayomi Samuel, PA, Mahesh, Pana, Adrian, Park, Eun-Kee, Patil, Snehal T., Patton, George C., Pedro, Joao, Qorbani, Mostafa, Rafay, Anwar, Rahman, Mahfuzar, Rai, Rajesh Kumar, Ram, Usha, Ranabhat, Chhabi Lal, Refaat, Amany H., Reinig, Nickolas, Roba, Hirbo Shore, Rodriguez, Alina, Roman, Yesenia, Roth, Gregory, Roy, Ambuj, Sagar, Rajesh, Salomon, Joshua, Sanabria, Juan, de Souza Santos, Itamar, Sartorius, Benn, Satpathy, Maheswar, Sawhney, Monika, Sawyer, Susan, Saylan, Mete, Schaub, Michael P., Schluger, Neil, Schutte, Aletta Elisabeth, Sepanlou, Sadaf G., Serdar, Berrin, Shaikh, Masood Ali, She, Jun, Shin, Min-Jeong, Shiri, Rahman, Shishani, Kawkab, Shiue, Ivy, Sigfusdottir, Inga Dora, Silverberg, Jonathan I., Singh, Jasvinder, Singh, Virendra, Slepak, Erica Leigh, Soneji, Samir, Soriano, Joan B., Soshnikov, Sergey, Sreeramareddy, Chandrashekhar T, Stein, Dan J., Stranges, Saverio, Subart, Michelle L., Swaminathan, Soumya, Szoeke, Cassandra E. I., Tefera, Worku Mekonnen, Topor-Madry, Roman, Tran, Bach, Tsilimparis, Nikolaos, Tymeson, Hayley, Ukwaja, Kingsley Nnanna, Updike, Rachel, Uthman, Olalekan A., Violante, Francesco Saverio, Vladimirov, Sergey K., Vlassov, Vasiliy, Vollset, Stein Emil, Vos, Theo, Weiderpass, Elisabete, Wen, Chi-Pan, Werdecker, Andrea, Wilson, Shelley, Wubshet, Mamo, Xiao, Lin, Yakob, Bereket, Yano, Yuichiro, Ye, Penpeng, Yonemoto, Naohiro, Yoon, Seok-Jun, Younis, Mustafa Z., Yu, Chuanhua, Zaidi, Zoubida, El Sayed Zaki, Maysaa, Zhang, Anthony Lin, Zipkin, Ben, Murray, Christopher J. L., 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: http://dx.doi.org/10.1016/S0140-6736(17)30819-X

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

Abstract

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

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