The methodology for assessing smoking-attributed mortality based on All Causes of Death Surveillance in Tianjin, China, 2010–2015

Abstract

INTRODUCTION The All Causes of Death Surveillance (ACDS) system was used to measure smoking-attributed mortality by inserting questions on smoking on death certificates. Smoking status information of the deceased has been routinely collected in death certificates since 2010. We describe a death registry-based case-control study using smoking and cause-of-death data for the period 2010-15. METHODS From 2010, three questions about the smoking status of the deceased were inserted in a revised death certificate: 1) Smoking status (current smoker, quit smoking, never smoker); 2) Number of cigarettes per day smoked; and 3) Number of years of smoking. A data-accuracy survey of 1788 telephone interviews of the family of the deceased was also conducted. Smoking habits (current/ex-smoker vs non-smoker) were compared in study cases (persons who died of lung cancer and other diseases known to be caused by smoking) and the controls (never smokers). Multivariate logistic regression analysis was conducted to estimate relative risks, RR (odds ratios) for smoking-attributed mortality, for lung cancer and all causes of death related to smoking, adjusted for 5-year interval age groups, education, marital status, and year of death. RESULTS During the study period (2010-15), the annual crude death reporting rates ranged from 6.5‰ to 7.0‰. The reporting rates of smoking status, smoking history and the number of cigarettes smoked daily were 95.5%, 98.6% and 98.6%, respectively. Compared to never smokers, the RR of ever smoking in males was 1.38 (95% CI: 1.33-1.43) for all causes of smoking-related deaths and 3.07 (95% CI: 2.91-3.24) for lung cancer, while in females the values were 1.46 (95% CI: 1.39-1.54) for all causes of smoking-related deaths and 4.07 (95% CI: 3.81-4.35) for lung cancer. The results in Tianjin are in accord with published results from previous studies. CONCLUSIONS Levels and trends in smoking attributed mortality can be measured at low cost by using the stable, complete and effective ACDS system in Tianjin.

Smoking cessation-associated mortality reduction: A case-control study in Tianjin city, China

“…The death registration system in Tianjin is the first and only death registration system which is collecting the smoking information of the deceased in China. Starting at the end of 2009, the current research group has been collecting information routinely on smokers including: smoking status (current smoking, quit smoking, never smoked); cigarettes/day; and years of smoking recorded on the death certificate 10 , 11 . In 2015, in order to further improve the collection of data, smoking information about the duration of smoking cessation was added (if the deceased had quit, the duration of smoking abstinence in years).…”

High sodium diet intake and cardiovascular diseases: An attributable death study in Tianjin, China

“…The death data of CVDs in 2015 were derived from the Tianjin All Cause of Death Surveillance System based on the ICD code of diseased, which covered the registered residence population of the city since 1984 18,19 …”

“…The death data of CVDs in 2015 were derived from the Tianjin All Cause of Death Surveillance System based on the ICD code of diseased, which covered the registered residence population of the city since 1984. 18 , 19 Previous studies showed that the health outcomes of CVDs related to elevated SBP included ischemic heart disease (ICD‐10:I20‐I25), rheumatic heart disease (I01, I02.0, I05‐I09), aortic aneurysm (I71), endocarditis, myocarditis and myocardial disease (I33, I40, I42), atrial fibrillation and peripheral neuropathy and other circulatory diseases (I48, I73, I70.2, I00, I02.9, I27‐I28, I30‐I32, I34‐I39, I47, I70.8, I72, I77‐I80, I82‐I84, I86‐ I98, G45), ischemic stroke (I63), and hemorrhagic stroke (I61). The relative risk (RR) per 10 mm Hg increase in SBP by age groups (aged 25 and over) and both sex for each health outcome was showed in Table S1 .…”