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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 Publisher Pubmed



Reitsma MB1 ; Fullman N1 ; Ng M1 ; Salama JS1 ; Abajobir A2 ; Abate KH3 ; Abbafati C4 ; Abera SF5, 7 ; Abraham B6 ; Abyu GY7 ; Adebiyi AO8 ; Alaly Z9 ; Aleman AV10 ; Ali R11 Show All Authors
Authors
  1. Reitsma MB1
  2. Fullman N1
  3. Ng M1
  4. Salama JS1
  5. Abajobir A2
  6. Abate KH3
  7. Abbafati C4
  8. Abera SF5, 7
  9. Abraham B6
  10. Abyu GY7
  11. Adebiyi AO8
  12. Alaly Z9
  13. Aleman AV10
  14. Ali R11
  15. Alkerwi AA12
  16. Allebeck P13
  17. Alraddadi RM14
  18. Amare AT15
  19. Amberbir A16
  20. Ammar W17
  21. Amrock SM18
  22. Antonio CAT19
  23. Asayesh H20
  24. Atnafu NT21, 22
  25. Azzopardi P23, 24
  26. Banerjee A25
  27. Barac A26
  28. Barrientosgutierrez T27
  29. Bastoabreu AC28
  30. Bazarganhejazi S29
  31. Bedi N30
  32. Bell B1
  33. Bello AK31
  34. Bensenor IM32
  35. Beyene AS33
  36. Bhala N34, 35
  37. Biryukov S1
  38. Bolt K1
  39. Brenner H36
  40. Butt Z37
  41. Cavalleri F10
  42. Cercy K1
  43. Chen H38
  44. Christopher DJ39
  45. Ciobanu LG40
  46. Colistro V10, 41
  47. Colomar M42
  48. Cornaby L1
  49. Dai X1
  50. Damtew SA43, 44
  51. Dandona L1, 45
  52. Dandona R1, 45
  53. Dansereau E1
  54. Davletov K46, 47
  55. Dayama A48
  56. Degfie TT49
  57. Deribew A11
  58. Dharmaratne SD16
  59. Dimtsu BD7
  60. Doyle KE50, 51
  61. Endries AY52
  62. Ermakov SP53, 54
  63. Estep K1
  64. Faraon EJA19, 55
  65. Farzadfar F56
  66. Feigin VL57
  67. Feigl AB58
  68. Fischer F59
  69. Friedman J1
  70. Ghiwot TT3
  71. Gall SL60
  72. Gao W61
  73. Gillum RF62
  74. Gold AL1
  75. Gopalani SV63
  76. Gotay CC64
  77. Gupta R65
  78. Gupta R65
  79. Gupta V67
  80. Hamadeh RR68
  81. Hankey G69, 70
  82. Harb HL17
  83. Hay SI1, 11
  84. Horino M71
  85. Horita N72
  86. Hosgood HD73
  87. Husseini A74
  88. Ileanu BV75
  89. Islami F76
  90. Jiang G77
  91. Jiang Y78
  92. Jonas JB79
  93. Kabir Z80
  94. Kamal R81
  95. Kasaeian A56
  96. Kesavachandran CN81
  97. Khader YS82
  98. Khalil I1
  99. Khang YH83
  100. Khera S84
  101. Khubchandani J85
  102. Kim D44
  103. Kim YJ86
  104. Kimokoti RW87
  105. Kinfu Y88
  106. Knibbs LD2
  107. Kokubo Y89
  108. Kolte D90
  109. Kopec J64
  110. Kosen S91
  111. Kotsakis GA1
  112. Koul PA92
  113. Koyanagi A93
  114. Krohn KJ1
  115. Krueger H64
  116. Defo BK94
  117. Bicer BK95
  118. Kulkarni C96
  119. Kumar GA97
  120. Leasher JL98
  121. Lee A1
  122. Leinsalu M99, 100
  123. Li T101
  124. Linn S103
  125. Liu P1
  126. Liu S102
  127. Lo LT104, 105
  128. Lopez AD23
  129. Ma S106, 107
  130. Abd El Razek HM108
  131. Majeed A109
  132. Malekzadeh R56
  133. Malta DC110
  134. Manamo WA44
  135. Martinezraga J111, 112
  136. Mekonnen AB113, 114
  137. Mendoza W115
  138. Miller TR116, 117
  139. Mohammad KA118, 119
  140. Morawska L120
  141. Musa KI121
  142. Nagel G122
  143. Neupane SP123
  144. Nguyen Q124
  145. Nguyen G1
  146. Oh IH125
  147. Oyekale AS126
  148. Pa M127
  149. Pana A128
  150. Park EK129
  151. Patil ST130
  152. Patton GC23
  153. Pedro J25
  154. Qorbani M131
  155. Rafay A132, 133
  156. Rahman M134, 135
  157. Rai RK136
  158. Ram U137
  159. Ranabhat CL138
  160. Refaat AH139, 140
  161. Reinig N1
  162. Roba HS33
  163. Rodriguez A109, 141
  164. Roman Y1
  165. Roth G1, 142
  166. Roy A48
  167. Sagar R48
  168. Salomon JA58
  169. Sanabria J15, 143
  170. De Souza Santos I32
  171. Sartorius B144
  172. Satpathy M48
  173. Sawhney M89
  174. Sawyer S23
  175. Saylan M145
  176. Schaub MP146
  177. Schluger N147
  178. Schutte AE148, 149
  179. Sepanlou SG56
  180. Serdar B150
  181. Shaikh MA151
  182. She J152
  183. Shin MJ153
  184. Shiri R154
  185. Shishani K155
  186. Shiue I156, 157
  187. Sigfusdottir ID158
  188. Silverberg JI159
  189. Singh J160
  190. Singh V161
  191. Slepak EL1
  192. Soneji S162
  193. Soriano JB163
  194. Soshnikov S54
  195. Sreeramareddy CT164
  196. Stein DJ165, 166
  197. Stranges S167
  198. Subart ML1
  199. Swaminathan S168
  200. Szoeke CEI23
  201. Tefera WM27, 169
  202. Topormadry R170
  203. Tran B171, 172
  204. Tsilimparis N173
  205. Tymeson H1
  206. Ukwaja KN174
  207. Updike R1
  208. Uthman OA167
  209. Violante FS175
  210. Vladimirov SK176
  211. Vlassov V177
  212. Vollset SE1, 178, 179
  213. Vos T1
  214. Weiderpass E13
  215. Wen CP180
  216. Werdecker A181
  217. Wilson S1
  218. Wubshet M182
  219. Xiao L183
  220. Yakob B144
  221. Yano Y159
  222. Ye P101
  223. Yonemoto N184
  224. Yoon SJ153
  225. Younis MZ185
  226. Yu C186
  227. Zaidi Z187
  228. Zaki MES188
  229. Zhang AL50
  230. Zipkin B1
  231. Murray CJL1
  232. Forouzanfar MH1
  233. Gakidou E1
Show Affiliations
Authors Affiliations
  1. 1. Institute for Health Metrics and Evaluation, University of Washington, Seattle, 98121, WA, United States
  2. 2. University of Queensland, Brisbane, QLD, Australia
  3. 3. Jimma University, Jimma, Ethiopia
  4. 4. La Sapienza, University of Rome, Rome, Italy
  5. 5. University of Hohenheim, Stuttgard, Germany
  6. 6. NMSM Governement College Kalpetta, Kerala, India
  7. 7. Mekelle University, Mekelle, Ethiopia
  8. 8. University of Ibadan, Ibadan, Nigeria
  9. 9. Washington University in Saint Louis, St Louis, MO, United States
  10. 10. University of the Republic, Montevideo, Uruguay
  11. 11. University of Oxford, Oxford, United Kingdom
  12. 12. Luxembourg Institute of Health (LIH), Strassen, Luxembourg
  13. 13. Karolinska Institutet, Stockholm, Sweden
  14. 14. Ministry of Health, Jeddah, Saudi Arabia
  15. 15. Marshall University, Huntington, WV, United States
  16. 16. Dignitas International, Zomba, Malawi
  17. 17. Ministry of Public Health, Beirut, Lebanon
  18. 18. Oregon Health and Science University, Portland, OR, United States
  19. 19. University of the Philippines Manila, Manila, Philippines
  20. 20. Qom University of Medical Sciences, Qom, Iran
  21. 21. Mizan Tepi University, Mizan Teferi, Ethiopia
  22. 22. PMA 2020, Addis Ababa, Ethiopia
  23. 23. University of Melbourne, Melbourne, VIC, Australia
  24. 24. Murdoch Childrens Research Institute, South Australian Health and Medical Research Institute, Adelaide, SA, Australia
  25. 25. Bucharest University of Economic Studies, Bucharest, Romania
  26. 26. University of Belgrade, Belgrade, Serbia
  27. 27. University of Adelaide, Adelaide, SA, Australia
  28. 28. University of Montreal, Montreal, QC, Canada
  29. 29. Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
  30. 30. College of Public Health and Tropical Medicine, Jazan, Saudi Arabia
  31. 31. University of Alberta, Edmonton, AB, Canada
  32. 32. University of Sao Paulo, Sao Paulo, Brazil
  33. 33. Haramaya University, Harar, Ethiopia
  34. 34. Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom
  35. 35. University of Otago Medical School, Otago, New Zealand
  36. 36. German Cancer Research Center, Heidelberg, Germany
  37. 37. Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan
  38. 38. Michigan State University, Lansing, MI, United States
  39. 39. Christian Medical College, Vellore, India
  40. 40. New York Medical College, Valhalla, NY, United States
  41. 41. Ministerio de Salud Publica, Montevideo, Uruguay
  42. 42. UNICEM, Montevideo, Uruguay
  43. 43. Wolaita Sodo University, Wolaita Sodo, Ethiopia
  44. 44. Addis Ababa University, Addis Ababa, Ethiopia
  45. 45. Public Health Foundation of India, New Delhi, India
  46. 46. Republican Institute of Cardiology and Internal Diseases, Almaty, Kazakhstan
  47. 47. Kazakh National Medical University, Almaty, Kazakhstan
  48. 48. All India Institute of Medical Sciences, New Delhi, India
  49. 49. African Population and Health Research Center, Nairobi, Kenya
  50. 50. RMIT University, Bundoora, VIC, Australia
  51. 51. Australian National University, Canberra, ACT, Australia
  52. 52. University of Peradeniya, Peradeniya, Sri Lanka
  53. 53. Russian Academy of Sciences, Moscow, Russian Federation
  54. 54. Ministry of Health of the Russian Federation, Moscow, Russian Federation
  55. 55. Department of Health, Manila, Philippines
  56. 56. Tehran University of Medical Sciences, Tehran, Iran
  57. 57. Auckland University of Technology, Auckland, New Zealand
  58. 58. Harvard University, Boston, MA, United States
  59. 59. Bielefeld University, Bielefeld, Germany
  60. 60. University of Tasmania, Hobart, TAS, Australia
  61. 61. Taipei Medical University, Taipei, Taiwan
  62. 62. Howard University, Washington, DC, United States
  63. 63. Government of the Federated States of Micronesia, Palikir, Federated States of Micronesia
  64. 64. University of British Columbia, Vancouver, BC, Canada
  65. 65. West Virginia Department of Health and Human Resources, Bureau for Public Health, Charleston, WV, United States
  66. 66. Eternal Heart Care Centre and Research Institute, Jaipur, India
  67. 67. University of Delhi, Delhi, India
  68. 68. Arabian Gulf University, Manama, Bahrain
  69. 69. University of Western Australia, Perth, WA, Australia
  70. 70. Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
  71. 71. Nevada Division of Public and Behavioral Health, Carson City, NV, United States
  72. 72. Yokohama City University Graduate School of Medicine, Yokohama, Japan
  73. 73. Albert Einstein College of Medicine, Bronx, NY, United States
  74. 74. Birzeit University, Birzeit, Palestine
  75. 75. National Institute of Public Health, Cuernavaca, Mexico
  76. 76. American Cancer Society, Atlanta, GA, United States
  77. 77. Tianjin Centers for Disease Control and Prevention, Tianjin, China
  78. 78. Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
  79. 79. Ruprecht-Karls-University Heidelberg, Mannheim, Germany
  80. 80. University College Cork, Cork, Ireland
  81. 81. CSIR-Indian Institute of Toxicology Research, Lucknow, India
  82. 82. Jordan University of Science and Technology, Irbid, Jordan
  83. 83. Seoul National University, Seoul, South Korea
  84. 84. Northeastern University, Boston, MA, United States
  85. 85. Ball State University, Muncie, IN, United States
  86. 86. Southern University College, Skudai, Malaysia
  87. 87. Simmons College, Boston, MA, United States
  88. 88. University of Canberra, Canberra, ACT, Australia
  89. 89. National Cerebral and Cardiovascular Center, Suita, Japan
  90. 90. Brown University, Providence, RI, United States
  91. 91. Health Policy and Humanities, NIHRD, Jakarta, Indonesia
  92. 92. Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
  93. 93. Parc Sanitari Sant Joan de Deu (CIBERSAM), Barcelona, Spain
  94. 94. BRAC, Dhaka, Bangladesh
  95. 95. Hacettepe University, Ankara, Turkey
  96. 96. Rajrajeswari Medical College and Hospital, Bangalore, India
  97. 97. Public Health Foundation of India, Guragon, India
  98. 98. Nova Southeastern University, Fort Lauderdale, FL, United States
  99. 99. National Institute for Health Development, Tallinn, Estonia
  100. 100. Sodertorn University, Huddinge, Sweden
  101. 101. National Center for Chronic and Noncommunicable Disease Control and Prevention, China
  102. 102. Chinese Center for Disease Control and Prevention, Beijing, China
  103. 103. University of Haifa, Haifa, Israel
  104. 104. UnionHealth Ass., LLC, St Louis, MO, United States
  105. 105. Alton Mental Health Center, Alton, IL, United States
  106. 106. Ministry of Health Singapore, Singapore, Singapore
  107. 107. National University of Singapore, Singapore, Singapore
  108. 108. Mansoura Faculty of Medicine, Mansoura, Egypt
  109. 109. Imperial College London, London, United Kingdom
  110. 110. Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
  111. 111. Hospital Universitario Doctor Peset, Valencia, Spain
  112. 112. CEU Cardinal Herrera University, Valencia, Spain
  113. 113. University of Gondar, Gondar, Ethiopia
  114. 114. University of Sydney, Sydney, NSW, Australia
  115. 115. United Nations Population Fund, Lima, Peru
  116. 116. Pacific Institute for Research and Evaluation, Calverton, United States
  117. 117. Curtin University, Bentley, WA, Australia
  118. 118. ISHIK University, Erbil, Iraq
  119. 119. University of Salahaddin, Erbil, Iraq
  120. 120. Queensland University of Technology, Brisbane, QLD, Australia
  121. 121. University of Science Malaysia, Kubang Kerian, Malaysia
  122. 122. Ulm University, Ulm, Germany
  123. 123. University of Oslo, Oslo, Norway
  124. 124. Duy Tan University, Da Nang, Viet Nam
  125. 125. Kyung Hee University, Seoul, South Korea
  126. 126. North-West University, Mafikeng, South Africa
  127. 127. JSS University, Mysore, India
  128. 128. National Institute of Public Health, Mexico City, Mexico
  129. 129. Kosin University, Busan, South Korea
  130. 130. School of Dental Sciences, Karad, India
  131. 131. Alborz University of Medical Sciences, Karaj, Iran
  132. 132. Contech International Health Consultants, Lahore, Pakistan
  133. 133. Contect School of Public Health, Lahore, Pakistan
  134. 134. St Paul's Hospital Millenium Medical College, Addis Ababa, Ethiopia
  135. 135. Addis Continental Institute of Public Health, Addis Ababa, Ethiopia
  136. 136. Society for Health and Demographic Surveillance, Suri, India
  137. 137. International Institute for Population Sciences, Mumbai, India
  138. 138. Yonsei University, Wonju, South Korea
  139. 139. Walden University, Minneapolis, MN, United States
  140. 140. Suez Canal University, Ismailia, Egypt
  141. 141. University of Lincoln, Lincoln, United Kingdom
  142. 142. Harborview Medical Center, Seattle, WA, United States
  143. 143. Case Western Reserve University, Cleveland, OH, United States
  144. 144. University of KwaZulu-Natal, Durban, South Africa
  145. 145. Bayer Turkey, Istanbul, Turkey
  146. 146. University of Zurich, Zurich, Switzerland
  147. 147. World Lung Association, New York, NY, United States
  148. 148. North-West University, Potchefstroom, South Africa
  149. 149. South African Medical Research Council, Tygerberg, South Africa
  150. 150. University of Colorado, Aurora, CO, United States
  151. 151. Karachi, Pakistan
  152. 152. Fudan University, Shanghai, China
  153. 153. Korea University, Seoul, South Korea
  154. 154. University of Helsinki, Helsinki, Finland
  155. 155. Washington State University, Spokane, WA, United States
  156. 156. Northumbria University, Newcastle upon Tyne, United Kingdom
  157. 157. University of Edinburgh, Edinburgh, United Kingdom
  158. 158. Reykjavik University, Reykjavik, Iceland
  159. 159. Northwestern University, Chicago, IL, United States
  160. 160. University of Alabama at Birmingham, Birmingham, AL, United States
  161. 161. Asthma Bhawan, Jaipur, India
  162. 162. Dartmouth University, Hanover, NH, United States
  163. 163. Universidad Autonoma de Madrid, Madrid, Spain
  164. 164. International Medical University, Kuala Lumpur, Malaysia
  165. 165. University of Cape Town, Cape Town, South Africa
  166. 166. South African Medical Research Council Unit On Anxiety and Stress Disorders, Tygerberg, South Africa
  167. 167. University of Warwick, Coventry, United Kingdom
  168. 168. Indian Council of Medical Research, Chennai, India
  169. 169. Bahir Dar University, Bahir Dar, Ethiopia
  170. 170. Jagiellonian University Medical College, Krakow, Poland
  171. 171. Johns Hopkins University, Baltimore, United States
  172. 172. Hanoi Medical University, Hanoi, Viet Nam
  173. 173. University Heart Center of Hamburg, Hamburg, Germany
  174. 174. University College London, London, United Kingdom
  175. 175. University of Bologna, Bologna, Italy
  176. 176. Federal Research Institute for Health Organization and Informatics, Moscow, Russian Federation
  177. 177. National Research University Higher School of Economics, Moscow, Russian Federation
  178. 178. Norwegian Institute of Public Health, Bergen, Norway
  179. 179. University of Bergen, Bergen, Norway
  180. 180. National Health Research Institutes, Taipei, Taiwan
  181. 181. Federal Institute for Population Research, Wiesbaden, Germany
  182. 182. College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
  183. 183. Emory University, Atlanta, GA, United States
  184. 184. Kyoto University, Kyoto, Japan
  185. 185. Jackson State University, Jackson, MS, United States
  186. 186. Wuhan University, Wuhan, China
  187. 187. University Hospital, Setif, Algeria
  188. 188. Mansoura University, Mansoura, Egypt

Source: The Lancet Published:2017


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 smoking attributable 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. © 2017 The Author(s). Published by Elsevier Ltd.
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