Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017.
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Date
2020
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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.
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Keywords
Global burden of disease, Quality-adjusted life years, Risk factors, Tobacco use
Citation
MALTA, D. C. et al. Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017. Population Health Metrics, v. 18, artigo 24, 2020. Disponível em: <https://pophealthmetrics.biomedcentral.com/articles/10.1186/s12963-020-00215-2>. Acesso em: 11 out. 2022.