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

GBD 2019 Tobacco Collaborators, 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 AjiChisom Joyqueenet Akunna, Ziyad Al-Aly, Turki M. Alanzi, Khalid F. Alhabib, Liaqat Ali, Sheikh Mohammad Alif, Vahid Alipour, Syed Mohamed Aljunid, François 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 Bärnighausen, 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, Giuseppe Gorini, Houman Goudarzi, Alessandra C. Goulart, Felix Greaves, Avirup Guha, Yuming Guo, Bhawna Gupta, Rajat Das Gupta, Rajeev Gupta, Tarun Gupta, Vin Gupta, Nima Hafezi-Nejad, Mohammad Rifat Haider, Randah R. Hamadeh, Graeme J. Hankey, Arief Hargono, Risky Kusuma Hartono, Hadi Hassankhani, Simon I. Hay, Golnaz Heidari, Claudiu Herteliu, Kamal Hezam, Thomas R. Hird, Michael K. Hole, Ramesh Holla, Mehdi Hosseinzadeh, Sorin Hostiuc, Mowafa Househ, Thomas Hsiao, Junjie Huang, Vincent C. Iannucci, Segun Emmanuel Ibitoye, Bulat Idrisov, Olayinka Stephen Ilesanmi, Irena M. Ilic, Milena D. Ilic, Leeberk Raja Inbaraj, Seyed Sina Naghibi Irvani, Jessica Y. Islam, Rakibul M. Islam, Sheikh Mohammed Shariful Islam, Farhad Islami, Hiroyasu Iso, Ramaiah Itumalla, Masao Iwagami, Jalil Jaafari, Vardhmaan Jain, Mihajlo Jakovljevic, Sung In Jang, Hosna Janjani, Shubha Jayaram, Panniyammakal Jeemon, Ravi Prakash Jha, Jost B. Jonas, Tamas Joo, Mikk Jürisson, Ali Kabir, Zubair Kabir, Leila R. Kalankesh, Tanuj Kanchan, Himal Kandel, Neeti Kapoor, Salah Eddin Karimi, Srinivasa Vittal Katikireddi, Hafte Kahsay Kebede, Bayew Kelkay, Ryan David Kennedy, Abdullah T. Khoja, Jagdish Khubchandani, Gyu Ri Kim, Young Eun Kim, Ruth W. Kimokoti, Mika Kivimäki, Soewarta Kosen, Sindhura Lakshmi Koulmane Laxminarayana, Ai Koyanagi, Kewal Krishan, Nuworza Kugbey, G. Anil Kumar, Nithin Kumar, Om P. Kurmi, Dian Kusuma, Ben Lacey, Jennifer O. Lam, Iván Landires, Savita Lasrado, Paolo Lauriola, Doo Woong Lee, Yo Han Lee, Janni Leung, Shanshan Li, Hualiang Lin, Shai Linn, Wei Liu, Alan D. Lopez, Platon D. Lopukhov, Stefan Lorkowski, Alessandra Lugo, Azeem Majeed, A. Rahman

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23 Citations (Scopus)

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. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.

Original languageEnglish
Pages (from-to)2337-2360
Number of pages24
JournalThe Lancet
Volume397
Issue number10292
Early online date27 May 2021
DOIs
Publication statusPublished - 19 Jun 2021

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