A global perspective on smoking’s impact on peptic ulcer disease: DALY trends and projections

Abstract

Objective: This study aims to analyze global trends in smoking-attributable peptic ulcer disease (PUD) disability-adjusted life years (DALYs) from 1990 to 2021 and project future trends to 2046. Methods: Data were obtained from the Global Burden of Disease Study 2021. We calculated age-standardized DALYs rates (ASDR) and estimated annual percentage changes (EAPC) for smoking-attributable PUD DALYs. Bayesian Age-Period-Cohort models were used to project future trends. Results: From 1990 to 2021, global smoking-attributable PUD DALYs decreased significantly, with the age-standardized rate declining from 35.4 to 9.4 per 100,000 (EAPC: −4.45%). High-income regions showed faster declines, while some low- and middle-income countries experienced slower progress or even increases. Gender disparities were observed, with males consistently showing higher ASDR. Projections suggest a continued global decline in smoking-attributable PUD DALYs to 2046, with persistent regional disparities. By 2046, the global ASDR is expected to decrease to approximately 3.2 per 100,000, with higher rates persisting in certain regions such as Kiribati (44.6 per 100,000) and Cambodia (45.1 per 100,000). Conclusion: While global smoking-attributable PUD DALYs have significantly decreased and are projected to continue declining, substantial regional and gender disparities persist. These findings underscore the need for targeted tobacco control interventions, particularly in high-risk regions and among vulnerable populations, to further reduce the global burden of smoking-attributable PUD.