Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017

Data de publicação

30 de setembro de 2020

Periódico

Population Health Metrics

Resumo

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.

DOI/link

doi.org/10.1186/s12963-020-00215-2

Autoria

Vínculo institucional

Lattes

Orcid

Deborah Carvalho Malta

Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais

Luisa Sorio Flor

Institute for Health Metrics and Evaluation (IHME), University of Washington

Ísis Eloah Machado

Programa de Pós-Graduação em Enfermagem, Escola de Enfermagem, Universidade Federal de Minas Gerais

Mariana Santos Felisbino-Mendes

Escola de Enfermagem, Departamento Materno Infantil e Saúde Pública, Universidade Federal de Minas Gerais

Antonio Luiz Pinho Ribeiro

Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais

Renato Azeredo Teixeira

Programa de Pós-Graduação em Saúde Pública da Faculdade de Medicina da Universidade Federal de Minas Gerais

Eduardo Marques Macário

Departamento de Análise e Vigilância em Saúde de Doenças Não Transmissíveis, Secretaria de Vigilância em Saúde, Ministério da Saúde

Luisa Campos Caldeira Brant

Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais

Marissa B. Reitsma

Institute for Health Metrics and Evaluation (IHME), University of Washington

Scott Glenn

Institute for Health Metrics and Evaluation (IHME), University of Washington

Mohsen Naghavi

Institute for Health Metrics and Evaluation (IHME), University of Washington

Emmanuela Gakidou

Institute for Health Metrics and Evaluation (IHME), University of Washington