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

Abstract

Summary 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.

Spatial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

“…Much of the previous research on the prevalence of chewing tobacco use has focused on a particular country, [18][19][20] region, 3,4,21 source, 3,[18][19][20][21] time period, 11,20,21 or age group, 5,22 making formation of a comprehensive global picture of where chewing tobacco is used most, among which age groups and sexes, and how these trends have changed over time very difficult. Our study is a step towards understanding this full picture so that policy makers, public health officials, and advocacy organi sations have access to a full set of comparable estimates for use in addressing this harmful substance.…”

“…11,14,17 In this context, we aimed to provide an improved understanding of chewing tobacco use, which is essential for targeted policy, assessment of the effectiveness of these policies, and, ultimately, mitigation of the associated harms. 1 Studies have been done previously that estimated prev a lence for a particular country, [18][19][20] region, 3,4,21 or source, 3,[18][19][20][21] or a restricted time period 11,20,21 or age group, 5,22 but to our knowledge no attempt has been made to synthesise multiple data sources to understand these trends globally over time and across age groups. For the first time, as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we compre hensively estimated the prevalence of chewing tobacco use using all available data sources to estimate age-sex-specific prevalence of chewing tobacco use from 1990 to 2019 in 204 countries and territories.…”

Female gender as a risk factor for developing COPD

“…The primary risk factors include cigarette smoking, although any long-term exposure to hazardous chemicals, dust and fumes could result in the initiation, development, and/or severity of COPD (Soriano et al, 2020[ 16 ]). The Global Burden of Disease report estimated the number of daily smokers was as high as 1.14 billion across 195 countries and territories in 2019, who consumed more than 7.41 trillion cigarette-equivalents of tobacco (Reitsma et al, 2021[ 14 ]). Indeed, smoking cessation is presently the most effective intervention that significantly slows the progression of COPD and reduces the disease severity (Tashkin, 2015[ 17 ]).…”

The effects of secondhand smoke on respiratory pathology, sensitization and development of allergic diseases in young children (literature review)

“…В Україні станом на 2019 р. поширеність активного куріння сягала серед жінок 14,4 % (95% ДІ 12,7-16,3) і УДК 616.24-008.4-056. 3 [1]. Лабораторними дослідженнями у тютюновому димі виявлено понад 4000 сполук, близько 50 з них -канцерогени, а більше ніж 450 -токсичні речовини, серед яких одна з основних -нікотин, алкалоїд з холіноміметичною дією, що викликає хімічну залежність.…”