학술논문
Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017.
Document Type
Academic Journal
Author
Malta DC; Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, n.° 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil. dcmalta@uol.com.br.; Postgraduate Program in Nursing, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. dcmalta@uol.com.br.; Flor LS; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA.; Machado ÍE; 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.; Felisbino-Mendes MS; Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, n.° 190, Santa Efigênia, Belo Horizonte, MG, CEP: 30130-100, Brazil.; Postgraduate Program in Nursing, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.; Brant LCC; Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.; Ribeiro ALP; Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.; Teixeira RA; Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.; Macário EM; Department of Health Analysis and Surveillance of Noncommunicable Diseases, Secretariat of Health Surveillance, Ministry of Health, Brasília, DF, Brazil.; Reitsma MB; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA.; Glenn S; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA.; Naghavi M; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA.; Gakidou E; Institute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WA, USA.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 101178411 Publication Model: Electronic Cited Medium: Internet ISSN: 1478-7954 (Electronic) Linking ISSN: 14787954 NLM ISO Abbreviation: Popul Health Metr Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The 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.
Methods: Prevalence 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.
Results: Between 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.
Conclusions: Brazil 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.
Methods: Prevalence 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.
Results: Between 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.
Conclusions: Brazil 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.