Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017
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RESEARCH
Open Access
Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017 Deborah Carvalho Malta1,2* , Luisa Sorio Flor3, Ísis Eloah Machado2,4, Mariana Santos Felisbino-Mendes1,2, Luisa Campos Caldeira Brant5, Antonio Luiz Pinho Ribeiro5, Renato Azeredo Teixeira6, Eduardo Marques Macário7, Marissa B. Reitsma3, Scott Glenn3, Mohsen Naghavi3 and Emmanuela Gakidou3
Abstract Background: The present study sought to analyze smoking prevalence and smoking-attributable mortality estimates produced by the 2017 Global Burden of Disease Study for Brazil, 26 states, and the Federal District. Methods: Prevalence of current smokers from 1990 to 2017 by sex and age was estimated using spatiotemporal Gaussian process regression. Population-attributable fractions were calculated for different risk-outcome pairs to generate estimates of smoking-attributable mortality. A cohort analysis of smoking prevalence by birth-year cohort was performed to better understand temporal age patterns in smoking. Smoking-attributable mortality rates were described and analyzed by development at state levels, using the Socio-Demographic Index (SDI). Finally, a decomposition analysis was conducted to evaluate the contribution of different factors to the changes in the number of deaths attributable to smoking between 1990 and 2017. Results: Between 1990 and 2017, prevalence of smoking in the population (≥ 20 years old) decreased from 35.3 to 11.3% in Brazil. This downward trend was seen for both sexes and in all states, with a marked reduction in exposure to this risk factor in younger cohorts. Smoking-attributable mortality rates decreased by 57.8% (95% UI − 61.2, − 54.1) between 1990 and 2017. Overall, larger reductions were observed in states with higher SDI (Pearson correlation 0.637; p < 0.01). In Brazil, smoking remains responsible for a considerable amount of deaths, especially due to cardiovascular diseases and neoplasms. Conclusions: Brazil has adopted a set of regulatory measures and implemented anti-tobacco policies that, along with improvements in socioeconomic conditions, have contributed to the results presented in the present study. Other regulatory measures need to be implemented to boost a reduction in smoking in order to reach the goals established in the scope of the 2030 United Nations Agenda for Sustainable Development. Keywords: Global burden of disease, Quality-adjusted life years, Risk factors, Smoking, Tobacco use
* Correspondence: [email protected] 1 Department of Maternal and Child Nursing and Public Health, Nursing School, Universidade Federal de Minas Gerais, Avenida Alfredo Balena, n.° 190, Santa Efigênia, Belo Horizonte, MG CEP: 30130-100, Brazil 2 Postgraduate Program in Nursing, Nursing School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permi
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