Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019
Marissa B ReitsmaParkes KendrickEmad AbabnehCristiana AbbafatiMohsen Abbasi‐KangevariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAmir AbdoliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAidin AbediE S AbhilashInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USADerrick Bary AbilaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAVictor AboyansInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USANiveen ME Abu-RmeilehInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAOladimeji AdebayoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAShailesh M AdvaniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMohammad AghaaliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USABright Opoku AhinkorahInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASohail AhmadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAKeivan AhmadiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAHaroon AhmedInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USABudi AjiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAChisom Joyqueenet AkunnaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAZiyad Al‐AlyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USATurki M AlanziInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAKhalid F. AlHabibInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USALiaqat AliInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASheikh Mohammad AlifInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAVahid AlipourInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASyed Mohamed AljunidInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAFrançois AllaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAPeter AllebeckInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USANelson Alvis‐GuzmánInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USATarek Tawfik AminInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASaeed AminiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAHubert AmuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAGianna Gayle Herrera AmulInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USARobert AncuceanuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJason A AndersonInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAlireza Ansari‐MoghaddamInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USACarl Abelardo T AntonioInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USABenny AntonyInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USADavood AnvariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJalal ArablooInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USANicholas ArianInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMonika AroraInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMalke AsaadInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMarcel AusloosInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAsma AwanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAGetinet AyanoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAGetie Lake AynalemInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASamad AzariInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAB B DarshanInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAshish BadiyeInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAtif Amin BaigInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMohammad Hossein BakhshaeiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMaciej BanachInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAPalash Chandra BanikInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASuzanne Barker‐ColloInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USATill BärnighausenInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAHiba Jawdat BarqawiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASanjay BasuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMohsen BayatiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAShahrzad Bazargan‐HejaziInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMasoud BehzadifarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USATariku Tesfaye BekumaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USADerrick BennettInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAIsabela M. BenseñorInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAKathleen S. BerfieldInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAkshaya Srikanth BhagavathulaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USANikha BhardwajInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAPankaj BhardwajInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAKrittika BhattacharyyaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASadia BibiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAli BijaniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USABagas Suryo BintoroInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAntonio BiondiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASetognal BiraraInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USADejana BraithwaiteInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAHermann BrennerInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAndré R. BrunoniInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAKatrin BurkartInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAZahid A ButtInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAFlorentino Luciano Caetano dos SantosLuis Alberto CámeraInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJosip CarInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USARosario CárdenasInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAGiulia CarrerasInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJuan Jesús CarreroInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJoão Maurício Castaldelli-MaiaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMaria Sofia CattaruzzaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAJung‐Chen ChangInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASimiao ChenInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USADinh‐Toi ChuInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USASheng‐Chia ChungInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAMassimo CírilloInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAVera Marisa CostaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USARosa A S CoutoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAOmid DadrasInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAXiaochen DaiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAAlbertino Antonio Moura DamascenoInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USAGiovanni DamianiInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USALalit DandonaInstitute for Health Metrics and Evaluation, University of Washington, Seattle, WA 98195 USA
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Аннотация
BACKGROUND: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. METHODS: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. FINDINGS: Globally in 2019, 1·14 billion (95% uncertainty interval 1·13-1·16) individuals were current smokers, who consumed 7·41 trillion (7·11-7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5% [26·5-28·5] reduction) and females (37·7% [35·4-39·9] reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98-1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16-8·20) deaths and 200 million (185-214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% [19·3-21·1] of male deaths). 6·68 million [86·9%] of 7·69 million deaths attributable to smoking tobacco use were among current smokers. INTERPRETATION: In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. FUNDING: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
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