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

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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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Malta, D. C., Flor, L. S., MacHado, Í. E., Felisbino-Mendes, M. S., Brant, L. C. C., Ribeiro, A. L. P., … Gakidou, E. (2020). Trends in prevalence and mortality burden attributable to smoking, Brazil and federated units, 1990 and 2017. Population Health Metrics, 18. https://doi.org/10.1186/s12963-020-00215-2

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