TY - JOUR
T1 - Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990-2019
T2 - a systematic analysis from the Global Burden of Disease Study 2019
AU - GBD 2019 Tobacco Collaborators
AU - Reitsma, Marissa B.
AU - Kendrick, Parkes J.
AU - Ababneh, Emad
AU - Abbafati, Cristiana
AU - Abbasi-Kangevari, Mohsen
AU - Abdoli, Amir
AU - Abedi, Aidin
AU - Abhilash, E. S.
AU - Abila, Derrick Bary
AU - Aboyans, Victor
AU - Abu-Rmeileh, Niveen ME
AU - Adebayo, Oladimeji M.
AU - Advani, Shailesh M.
AU - Aghaali, Mohammad
AU - Ahinkorah, Bright Opoku
AU - Ahmad, Sohail
AU - Ahmadi, Keivan
AU - Ahmed, Haroon
AU - Aji, Budi
AU - Akunna, Chisom Joyqueenet
AU - Al-Aly, Ziyad
AU - Alanzi, Turki M.
AU - Alhabib, Khalid F.
AU - Ali, Liaqat
AU - Alif, Sheikh Mohammad
AU - Alipour, Vahid
AU - Aljunid, Syed Mohamed
AU - Alla, François
AU - Allebeck, Peter
AU - Alvis-Guzman, Nelson
AU - Amin, Tarek Tawfik
AU - Amini, Saeed
AU - Amu, Hubert
AU - Amul, Gianna Gayle Herrera
AU - Ancuceanu, Robert
AU - Anderson, Jason A.
AU - Ansari-Moghaddam, Alireza
AU - Antonio, Carl Abelardo T.
AU - Antony, Benny
AU - Anvari, Davood
AU - Arabloo, Jalal
AU - Arian, Nicholas D.
AU - Arora, Monika
AU - Asaad, Malke
AU - Ausloos, Marcel
AU - Awan, Asma Tahir
AU - Ayano, Getinet
AU - Aynalem, Getie Lake
AU - Azari, Samad
AU - Shalash, A. S.
N1 - Publisher Copyright:
© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2021/6/19
Y1 - 2021/6/19
N2 - 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.
AB - 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.
KW - Adult
KW - Age Distribution
KW - Aged
KW - Female
KW - Global Burden of Disease
KW - Global Health
KW - Humans
KW - Male
KW - Middle Aged
KW - Prevalence
KW - Quality-Adjusted Life Years
KW - Sex Factors
KW - Smoking/epidemiology
KW - Socioeconomic Factors
KW - Surveys and Questionnaires
KW - Tobacco Use/epidemiology
UR - https://www.scopus.com/pages/publications/85108062100
U2 - 10.1016/S0140-6736(21)01169-7
DO - 10.1016/S0140-6736(21)01169-7
M3 - Article
C2 - 34051883
AN - SCOPUS:85108062100
SN - 0140-6736
VL - 397
SP - 2337
EP - 2360
JO - Lancet
JF - Lancet
IS - 10292
ER -