Evolution of mortality attributable to passive smoking in the 27 Brazilian capitals, 2009–2021

Abstract

Objective: To estimate the mortality attributable to passive smoking in the population aged 35 years old and older, by gender, in the 27 Brazilian state capitals, from 2009 to 2021. Methods: A prevalence-dependent method was used, based on the calculation of population attributable fractions (PAF). Deaths from diseases causally related to passive smoking were obtained from the Mortality Information System of the Brazilian Unified Health System (SIM/SUS); prevalence data were taken on SHS exposure were obtained from Vigitel surveys (2009–2021); and relative risks were obtained from a meta-analysis. Mortality attributable to passive smoking and mortality rates were estimated by capital city, year, gender, and cause of death. Trends in crude mortality rates attributable to passive smoking were analyzed using joinpoint regression models. Results: Passive smoking accounted for 64,913 deaths in all Brazilian state capitals between 2009 and 2021. Cardiovascular diseases were the main cause of death in both genders. The mortality rate attributed to passive smoking decreased from 33.1/100,000 deaths in 2009 to 15.4/100,000 deaths in 2021. This reduction was observed in all 27 Brazilian state capitals, both overall and by gender. Conclusion: Passive smoking was responsible for 1.4 of all deaths in Brazil during the period 2009-2021 and showed a favorable trend, with rates decreasing by half during the period.