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

Reitsma, M. B. et al. (2021) 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. Lancet, 397(10292), pp. 2337-2360. (doi: 10.1016/S0140-6736(21)01169-7) (PMID:34051883) (PMCID:PMC8223261)

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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.

Item Type:Articles
Additional Information:Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation. SheMA acknowledges support from Monash University, VIC, Australia. SyMA would like to acknowledge the International Centre for Casemix and Clinical Coding, Faculty of Medicine, National University of Malaysia and Department of Health Policy and Management, Faculty of Public Health, Kuwait University for the approval and support to participate in this research project. MarA, AdP, and CH are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation (CNDS-UEFISCDI, project number PN-III-P4-ID-PCCF-2016-0084). TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt Professor award, funded by the German Federal Ministry of Education and Research. SB-H was supported by National Institutes of Health (NIH) National Center for Advancing Translational Science (NCATS) UCLA (CTSI grant number UL1TR001881). DAB research receives support from the Oxford National Institute for Health Research (NIHR) Biomedical Research Centre (BRC). VMC acknowledges her grant (SFRH/BHD/110001/2015), received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006. AD acknowledges funding support from the NIHR Applied Research Collaboration (ARC) South London at King's College Hospital NHS Foundation Trust and the Royal College of Physicians, as well as the support from the NIHR BRC based at Guy's and St Thomas' NHS Foundation Trust and King's College London. MEK was supported by FIU University Graduate School Dissertation Year Fellowship. PSG is supported by the NIHR Applied Research Collaborations West Midland; the NIHR Global Health Research Unit on Improving Health in Slums at the University of Warwick; and the NIHR Global Health Group on Addressing Smokeless Tobacco Use & Building Research Capacity in South Asia at the University of York. CH and AdP are partially supported by a grant of the Romanian National Authority for Scientific Research and Innovation (CNDS-UEFISCDI, project number PN-III-P2-2.1-SOL-2020-2-0351). JYI is supported by UNC's Cancer Care Quality Training 2T32CA116339-11. SMSI is funded by the National Heart Foundation of Australia and NHMRC. MihJ acknowledges funding through grant OI 175 014 of the Ministry of Education Science and Technological Development of the Republic of Serbia. PJ acknowledges the Wellcome Trust/DBT India Alliance Fellowship support (IA/CPHI/14/1/501497). HK acknowledges being the Kornhauser Research Associate at The University of Sydney, Save Sight Institute. SVK acknowledges funding from a NHS Research Scotland Senior Clinical Fellowship (SCAF/15/02), the Medical Research Council (MC_UU_00022/2) and the Scottish Government Chief Scientist Office (SPHSU13). SLKL acknowledges support by the Manipal Academy of Higher Education. KK is supported by the UGC Centre of Advanced Study (CAS II) awarded to the Department of Anthropology, Panjab University, Chandigarh, India. BL acknowledges support from UK Biobank, the NIHR Oxford BRC, and the BHF Oxford Centre of Research Excellence. IL is member of the Sistema Nacional de Investigación (SNI), which is supported by the Secretaría Nacional de Ciencia, Tecnología e Innovación (SENACYT), Panamá. StL acknowledges institutional support from the Competence Cluster for Nutrition and Cardiovascular Health (nutriCARD) Halle-Jena-Leipzig (Germany; German Federal Ministry of Education and Research; grant agreement number 01EA1808A). RGP is supported in part by funding from the NIH National Cancer Institute (R01CA132115, R21CA235139-01) and the Breast Cancer Research Program (W81XWH1810605, Breakthrough Award) from the Department of Defense. PriR acknowledges the Manipal Academy of Higher Education, Manipal. AMS acknowledges the support from a fellowship from the Egyptian Fulbright Mission Program. MMS-M acknowledges the support of the Ministry of Education, Science and Technological Development of the Republic of Serbia (contract number 175087). AzS acknowledges support from the HDRUK BREATHE Hub. JPS acknowledges support from Applied Molecular Biosciences Unit (UCIBIO; grant number UIDB/04378/2020), supported through Portuguese national funds via FCT/MCTES. AmbS is supported by the International Graduate Research Scholarship, University of Tasmania. JBS is part of the Centro de Investigación en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Madrid, Spain. SKT acknowledges support from an NHMRC Early Career Fellowship.
Glasgow Author(s) Enlighten ID:Katikireddi, Professor Vittal
Authors: Reitsma, M. B., Kendrick, P. J., Ababneh, E., Abbafati, C., Abbasi-Kangevari, M., Abdoli, A., Abedi, A., Abhilash, E.S., Abila, D. B., Aboyans, V., Abu-Rmeileh, N. M.E., Adebayo, O. M., Advani, S. M., Aghaali, M., Ahinkorah, B. O., Ahmad, S., Ahmadi, K., Ahmed, H., Aji, B., Akunna, C. J., Al-Aly, Z., Alanzi, T. M., Alhabib, K. F., Ali, L., Alif, S. M., Alipour, V., Aljunid, S. M., Alla, F., Allebeck, P., Alvis-Guzman, N., Amin, T. T., Amini, S., Amu, H., Amul, G. G. H., Ancuceanu, R., Anderson, J. A., Ansari-Moghaddam, A., Antonio, C. A. T., Antony, B., Anvari, D., Arabloo, J., Arian, N. D., Arora, M., Asaad, M., Ausloos, M., Awan, A. T., Ayano, G., Aynalem, G. L., Azari, S., B, D. B., Badiye, A. D., Baig, A. A., Bakhshaei, M. H., Banach, M., Banik, P. C., Barker-Collo, S. L., Bärnighausen, T. W., Barqawi, H. J., Basu, S., Bayati, M., Bazargan-Hejazi, S., Behzadifar, M., Bekuma, T. T., Bennett, D. A., Bensenor, I. M., Berfield, K. S. S., Bhagavathula, A. S., Bhardwaj, N., Bhardwaj, P., Bhattacharyya, K., Bibi, S., Bijani, A., Bintoro, B. S., Biondi, A., Birara, S., Braithwaite, D., Brenner, H., Brunoni, A. R., Burkart, K., Butt, Z. A., Caetano dos Santos, F. L., Cámera, L. A., Car, J., Cárdenas, R., Carreras, G., Carrero, J. J., Castaldelli-Maia, J. M., Cattaruzza, M. S. S., Chang, J.-C., Chen, S., Chu, D.-T., Chung, S.-C., Cirillo, M., Costa, V. M., Couto, R. A.S., Dadras, O., Dai, X., Damasceno, A. A. M., Damiani, G., Dandona, L., Dandona, R., Daneshpajouhnejad, P., Darega Gela, J., Davletov, K., Derbew Molla, M., Dessie, G. A., Desta, A. A., Dharmaratne, S. D., Dianatinasab, M., Diaz, D., Do, H. T., Douiri, A., Duncan, B. B., Duraes, A. R., Eagan, A. W., Ebrahimi Kalan, M., Edvardsson, K., Elbarazi, I., El Tantawi, M., Esmaeilnejad, S., Fadhil, I., Faraon, E. J. A., Farinha, C. S. e. S., Farwati, M., Farzadfar, F., Fazlzadeh, M., Feigin, V. L., Feldman, R., Fernandez Prendes, C., Ferrara, P., Filip, I., Filippidis, F., Fischer, F., Flor, L. S., Foigt, N. A., Folayan, M. O., Foroutan, M., Gad, M. M., Gaidhane, A. M., Gallus, S., Geberemariyam, B. S., Ghafourifard, M., Ghajar, A., Ghashghaee, A., Giampaoli, S., Gill, P. S., Glozah, F. N., Gnedovskaya, E. V., Golechha, M., Gopalani, S. V., Gorini, G., Goudarzi, H., Goulart, A. C., Greaves, F., Guha, A., Guo, Y., Gupta, B., Gupta, R. D., Gupta, R., Gupta, T., Gupta, V., Hafezi-Nejad, N., Haider, M. R., Hamadeh, R. R., Hankey, G. J., Hargono, A., Hartono, R. K., Hassankhani, H., Hay, S. I., Heidari, G., Herteliu, C., Hezam, K., Hird, T. R., Hole, M. K., Holla, R., Hosseinzadeh, M., Hostiuc, S., Househ, M., Hsiao, T., Huang, J., Iannucci, V. C., Ibitoye, S. E., Idrisov, B., Ilesanmi, O. S., Ilic, I. M., Ilic, M. D., Inbaraj, L. R., Irvani, S. S. N., Islam, J. Y., Islam, R. M., Islam, S. M. S., Islami, F., Iso, H., Itumalla, R., Iwagami, M., Jaafari, J., Jain, V., Jakovljevic, M., Jang, S.-I., Janjani, H., Jayaram, S., Jeemon, P., Jha, R. P., Jonas, J. B., Joo, T., Jürisson, M., Kabir, A., Kabir, Z., Kalankesh, L. R., Kanchan, T., Kandel, H., Kapoor, N., Karimi, S. E., Katikireddi, r. V., Kebede, H. K., Kelkay, B., Kennedy, R. D., Khoja, A. T., Khubchandani, J., Kim, G. R., Kim, Y.-E., Kimokoti, R. W., Kivimäki, M., Kosen, S., Koulmane Laxminarayana, S. L., Koyanagi, A., Krishan, K., Kugbey, N., Kumar, G. A., Kumar, N., Kurmi, O. P., Kusuma, D., Lacey, B., Lam, J. O., Landires, I., Lasrado, S., Lauriola, P., Lee, D. W., Lee, Y. H., Leung, J., Li, S., Lin, H., Linn, S., Liu, W., Lopez, A. D., Lopukhov, P. D., Lorkowski, S., Lugo, A., Majeed, A., Maleki, A., Malekzadeh, R., Malta, D. C., Mamun, A. A., Manjunatha, N., Mansouri, B., Mansournia, M. A., Martinez-Raga, J., Martini, S., Mathur, M. R., Medina-Solís, C. E., Mehata, S., Mendoza, W., Menezes, R. G., Meretoja, A., Meretoja, T. J., Miazgowski, B., Michalek, I. M., Miller, T. R., Mirrakhimov, E. M., Mirzaei, H., Mirzaei-Alavijeh, M., Misra, S., Moghadaszadeh, M., Mohammad, Y., Mohammadian-Hafshejani, A., Mohammed, S., Mokdad, A. H., Monasta, L., Moni, M. A., Moradi, G., Moradi-Lakeh, M., Moradzadeh, R., Morrison, S. D., Mossie, T. B., Mubarik, S., Mullany, E. C., Murray, C. J.L., Naghavi, M., Naghshtabrizi, B., Nair, S., Nalini, M., Nangia, V., Naqvi, A. A., Narasimha Swamy, S., Naveed, M., Nayak, S., Nayak, V. C., Nazari, J., Nduaguba, S. O., Neupane Kandel, S., Nguyen, C. T., Nguyen, H. L. T., Nguyen, S. H., Nguyen, T. H., Nixon, M. R., Nnaji, C. A., Norrving, B., Noubiap, J. J., Nowak, C., Ogbo, F. A., Oguntade, A. S., Oh, I.-H., Olagunju, A. T., Oren, E., Otstavnov, N., Otstavnov, S. S., Owolabi, M. O., P A, M., Pakhale, S., Pakshir, K., Palladino, R., Pan, L., Pana, A., Panda-Jonas, S., Pandey, A., Parekh, U., Park, E.-C., Park, E.-K., Pashazadeh Kan, F., Patton, G. C., Pawar, S., Pestell, R. G., Pinheiro, M., Piradov, M. A., Pirouzpanah, S., Pokhrel, K. N., Polibin, R. V., Prashant, A., Pribadi, D. R. A., Radfar, A., Rahimi-Movaghar, V., Rahman, A., Rahman, M. H. U., Rahman, M. A., Rahmani, A. M., Rajai, N., Ram, P., Ranabhat, C. L., Rathi, P., Rawal, L., Renzaho, A. M.N., Reynales-Shigematsu, L. M., Rezapour, A., Riahi, S. M., Riaz, M. A., Roever, L., Ronfani, L., Roshandel, G., Roy, A., Roy, B., Sacco, S., Saddik, B., Sahebkar, A., Salehi, S., Salimzadeh, H., Samaei, M., Samy, A. M., Santos, I. S., Santric-Milicevic, M. M., Sarrafzadegan, N., Sathian, B., Sawhney, M., Saylan, M., Schaub, M. P., Schmidt, M. I., Schneider, I. J. C., Schutte, A. E., Schwendicke, F., Seidu, A.-A., Senthil Kumar, N., Sepanlou, S. G., Seylani, A., Shafaat, O., Shah, S. M., Shaikh, M. A., Shalash, A. 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R., Vardavas, C., Varona Pérez, P., Vasankari, T. J., Venketasubramanian, N., Verma, M., Vetrova, M. V., Vo, B., Vu, G. T., Waheed, Y., Wang, Y., Welding, K., Werdecker, A., Whisnant, J. L., Wickramasinghe, N. D., Yamagishi, K., Yandrapalli, S., Yatsuya, H., Yazdi-Feyzabadi, V., Yeshaw, Y., Yimmer, M. Z., Yonemoto, N., Yu, C., Yunusa, I., Yusefzadeh, H., Zahirian Moghadam, T., Zaman, M. S., Zamanian, M., Zandian, H., Zar, H. J., Zastrozhin, M. S., Zastrozhina, A., Zavala-Arciniega, L., Zhang, J., Zhang, Z.-J., Zhong, C., Zuniga, Y. M. H., and Gakidou, E.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU
Journal Name:Lancet
ISSN (Online):1474-547X
Published Online:27 May 2021
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in Lancet 397(10292): 2337-2360
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
Inequalities in healthMedical Research Council (MRC)MC_UU_00022/2HW - MRC/CSO Social and Public Health Sciences Unit
172690Understanding the impacts of welfare policy on health: A novel data linkage studySrinivasa KatikireddiOffice of the Chief Scientific Adviser (CSO)SCAF/15/02HW - Public Health
Chief Scientist Office (CSO)SPHSU13