小柯机器人

全球疾病负担2019烟草协作组研究了1990-2019年204个国家和地区吸烟流行率和可归因疾病负担的空间、时间和人口模式。2021年5月27日，该成果发表在《柳叶刀》杂志上。

结束全球烟草流行是全球卫生的一个决定性挑战。需要及时和全面地评估吸烟烟草使用率和归因疾病负担，以指导国家和全球的烟草控制工作。

作为全球疾病负担、伤害和风险因素研究的一部分，研究组按年龄和性别估计了1990-2019年204个国家和地区的吸烟率和归因疾病负担。研究组模拟了3625项全国代表性调查中与吸烟有关的多项指标。

研究组完成了系统评价，并对36个因果相关的健康结局进行了贝叶斯元回归分析，以估计目前和以前吸烟者的非线性剂量-反应风险曲线。研究组使用直接估计方法来估计归因负担，提供了比以前更全面的吸烟对健康影响的估计。

2019年，全球共有1.14亿的吸烟者，他们在2019年消费了7.41万亿支香烟当量的烟草。尽管自1990年以来，15岁及以上的男性（减少27.5%）和女性（减少37.7%）吸烟率都显著下降，但人口增长导致吸烟总人数从1990年的0.99亿显著增加。

2019年，全球吸烟死亡人数为769万，残疾调整寿命为2亿，且是男性死亡的主要危险因素（占男性死亡人数的20.2%）。在因吸烟而死亡的7.69亿人中，有6.68亿人（86.9%）是当前持续吸烟者。

总之，如果不采取干预措施，在未来几十年中，每年因吸烟造成的769万人死亡和2亿残疾调整寿命将增加。各区域和各个发展阶段的国家在降低吸烟率方面都取得了实质性进展，但在烟草控制方面仍存在很大的执行差距。各国应采取强有力的循证政策，加速降低吸烟率，并为其公民带来巨大的健康获益。

附：英文原文

Title: 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

Author: Marissa B Reitsma, Parkes J Kendrick, Emad Ababneh, Cristiana Abbafati, Mohsen Abbasi-Kangevari, Amir Abdoli, Aidin Abedi, E S Abhilash, Derrick Bary Abila, Victor Aboyans, Niveen ME Abu-Rmeileh, Oladimeji M Adebayo, Shailesh M Advani, Mohammad Aghaali, Bright Opoku Ahinkorah, Sohail Ahmad, Keivan Ahmadi, Haroon Ahmed, Budi Aji, Chisom Joyqueenet Akunna, Ziyad Al-Aly, Turki M Alanzi, Khalid F Alhabib, Liaqat Ali, Sheikh Mohammad Alif, Vahid Alipour, Syed Mohamed Aljunid, Franois Alla, Peter Allebeck, Nelson Alvis-Guzman, Tarek Tawfik Amin, Saeed Amini, Hubert Amu, Gianna Gayle Herrera Amul, Robert Ancuceanu, Jason A Anderson, Alireza Ansari-Moghaddam, Carl Abelardo T Antonio, Benny Antony, Davood Anvari, Jalal Arabloo, Nicholas D Arian, Monika Arora, Malke Asaad, Marcel Ausloos, Asma Tahir Awan, Getinet Ayano, Getie Lake Aynalem, Samad Azari, Darshan B B, Ashish D Badiye, Atif Amin Baig, Mohammad Hossein Bakhshaei, Maciej Banach, Palash Chandra Banik, Suzanne Lyn Barker-Collo, Till Winfried Brnighausen, Hiba Jawdat Barqawi, Sanjay Basu, Mohsen Bayati, Shahrzad Bazargan-Hejazi, Masoud Behzadifar, Tariku Tesfaye Bekuma, Derrick A Bennett, Isabela M Bensenor, Kathleen S Sachiko Berfield, Akshaya Srikanth Bhagavathula, Nikha Bhardwaj, Pankaj Bhardwaj, Krittika Bhattacharyya, Sadia Bibi, Ali Bijani, Bagas Suryo Bintoro, Antonio Biondi, Setognal Birara, Dejana Braithwaite, Hermann Brenner, Andre R Brunoni, Katrin Burkart, Zahid A Butt, Florentino Luciano Caetano dos Santos, Luis Alberto Cámera, Josip Car, Rosario Cárdenas, Giulia Carreras, Juan J Carrero, Joao Mauricio Castaldelli-Maia, Maria Sofia Sofia Cattaruzza, Jung-Chen Chang, Simiao Chen, Dinh-Toi Chu, Sheng-Chia Chung, Massimo Cirillo, Vera Marisa Costa, Rosa A S Couto, Omid Dadras, Xiaochen Dai, Albertino Antonio Moura Damasceno, Giovanni Damiani, Lalit Dandona, Rakhi Dandona, Parnaz Daneshpajouhnejad, Jiregna Darega Gela, Kairat Davletov, Meseret Derbew Molla, Getenet Ayalew Dessie, Abebaw Alemayehu Desta, Samath Dhamminda Dharmaratne, Mostafa Dianatinasab, Daniel Diaz, Hoa Thi Do, Abdel Douiri, Bruce B Duncan, Andre Rodrigues Duraes, Arielle Wilder Eagan, Mohammad Ebrahimi Kalan, Kristina Edvardsson, Iffat Elbarazi, Maha El Tantawi, Saman Esmaeilnejad, Ibtihal Fadhil, Emerito Jose A Faraon, Carla Sofia e Sá Farinha, Medhat Farwati, Farshad Farzadfar, Mehdi Fazlzadeh, Valery L Feigin, Rachel Feldman, Carlota Fernandez Prendes, Pietro Ferrara, Irina Filip, Filippos Filippidis, Florian Fischer, Luisa Sorio Flor, Nataliya A Foigt, Morenike Oluwatoyin Folayan, Masoud Foroutan, Mohamed M Gad, Abhay Motiramji Gaidhane, Silvano Gallus, Biniyam Sahiledengle Geberemariyam, Mansour Ghafourifard, Alireza Ghajar, Ahmad Ghashghaee, Simona Giampaoli, Paramjit Singh Gill, Franklin N Glozah, Elena V Gnedovskaya, Mahaveer Golechha, Sameer Vali Gopalani

Issue&Volume: 2021-05-27

Abstract:

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.

DOI: 10.1016/S0140-6736(21)01169-7

Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)01169-7/fulltext

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