| ObjectiveTo provide scientific basis for the government to formulate and implement tobacco control strategies and measures,we calculate the values and trends of the deaths attributed to smoking among Chinese residents of different provinces,genders and ages from 2010 to 2018.MethodsThe data of Chronic Disease Risk Factor Surveillance in China in 2010,2013,2015 and 2018,as well as covariate data are used to obtain the smoking exposure level of people aged 30 years and above in China from 2010 to 2018.According to the latest methods for calculating the PAF values of smoking based on the Global Burden of Disease(GBD)and the dose-response relationship between different amounts of smoking or years since quitting smoking and death from related diseases provided by GBD.Combined with the distribution of smoking amount and years of smoking cessation among different populations,the PAF of 27 smoking-related diseases in different provinces,ages and sexes was obtained.The death levels of 27 smoking-related diseases in different provinces,ages and genders were obtained from Cause-of-Death Reporting System from 2010 to 2018.The number of deaths and mortality rates of different diseases caused by smoking were calculated based on PAF values,mortality data and population data in different provinces.The level of smoking-attributable death by sex,age,disease,PAF by province was compared from 2010 to 2018,and the causes were analyzed and discussed.Results1.Results of smoking exposure level(1)Among the male population,the current smoking rate is higher than the never-smoking rate,and the current smoking rate is declining.The current smoking rate is 51.1%in 2018.Among women,the never-smoking rate is much higher than the current smoking rate,which was 2.45%for women in 2018.In the whole population,the never smoking rate is higher than the current smoking rate,and the current smoking rate shows a downward trend,with the result of 26.94%in 2018.Smoking rates among men are much higher than among women(2)Among men,the current smoking rate first increases and then decreases with age,with the highest smoking rate in the 45-49 age group.Among women,smoking rates now increase with age,reaching their highest levels in the 70-74 and 75-79 age groups,and then decreasing.In the whole population,smoking now first increases with age and then decreases.It was highest in the 45-49 and 55-59 age groups.2.Results of PAF(1)In the male population,the PAF of various diseases firstly increased and then decreased with the increase of age,and the PAF value of most diseases was highest in the group of 50-54 and 55-59 years old,while the PAF value was lowest in the group of 80 years and above.In the female population,the PAF of various diseases firstly increased and then decreased with the increase of age,and the PAF value of most diseases was highest in the high age group of 70-74,75-79 and 80 years old and above,while it was lowest in the age group of 30-34 years old.For each of these diseases,men had higher PAF than women in any age group(except for prostate,breast,and cervical cancers).(2)In the male population,the highest PAF was found in throat cancer,with a PAF of 84.40%in 2018.This was followed by trachea,bronchus and lung cancer,chronic obstructive pulmonary disease,aortic aneurysm,and esophageal cancer.The lowest were in prostate cancer,gallbladder and biliary tract disease,colon and rectal cancer,type 2 diabetes and rheumatoid arthritis.In the female population,the highest PAF was found in throat cancer,with a PAF of 25.18%in 2018.It was followed by trachea,bronchus and lung cancer,chronic obstructive pulmonary disease,aortic aneurysm,and lip and mouth cancer.The lowest were breast cancer,gallbladder and biliary tract disease,liver cancer,type 2 diabetes and rheumatoid arthritis.In the whole population aged 30 years old and above,the disease with the highest PAF was laryngeal cancer,which was 76.05%in 2018.The following were trachea,bronchus and lung cancer,aortic aneurysm,esophageal cancer and chronic obstructive pulmonary disease(COPD).The lowest diseases(excluding breast,cervical and prostate cancer)were gallbladder and biliary tract disease,rheumatoid arthritis,type 2 diabetes,colon and rectal cancer and asthma.(3)In the male population,the value of all-cause PAF of 27 diseases first increased and then decreased with the increase of age,and the total PAF value was the highest in the 55-59 age group,which was as high as 49.29%in 2018.The 30-34 age group had the lowest total PAF,which was 30.60%in 2018.In the female population,the all-cause PAF value firstly increased and then decreased with age,and the highest value was found in the 75-79 age group,which was as high as 11.91%in 2018.The lowest was in the 30-34 age group,which was 0.86%in 2018.In the whole population,the value of PAF of all causes of death firstly increased and then decreased with the increase of age,and the value of PAF of all causes of death was the highest in the 55-59 and 60-64 age group,and the lowest in the 30-34 and 80 years and above age group.(4)The all-cause PAF value of 27 diseases in men was about 41%,and the total PAF value in the male population showed a downward trend from 2010 to 2015,and increased slightly after 2015.Moreover,the all-cause PAF value in male population is much higher than that in female population,and the all-cause PAF value in female population is about 8%.The value of all-cause PAF in the whole population decreased from 28.87%in 2010 to 26.9%in 2018.(5)In male population,the PAF of all causes of death was higher in Chongqing,Sichuan,Yunnan,Gansu and Zhejiang provinces,and lower in Beijing,Xinjiang,Liaoning,Tibet and Shanghai provinces.In female population,the PAF value of all causes of death was higher in Heilongjiang,Inner Mongolia,Liaoning,Shandong and Jilin provinces,while the PAF value of all causes of death was lower in Shanghai,Fujian and Hainan,Tibet and Henan provinces.In the whole population,the PAF value of all causes of death was higher in Heilongjiang,Sichuan,Inner Mongolia,Chongqing and Guizhou provinces,and lower in Tibet,Shanghai,Xinjiang,Henan and Guangxi provinces.3.Deaths from diseases caused by smoking(1)Overall,the number of attributable deaths increased from 1,762,600 in 2010 to 2,242,900 in 2018.The leading causes of death and mortality from smoking-related diseases are stroke,ischemic heart disease,chronic obstructive pulmonary disease,tracheal,bronchial and lung cancer and lower respiratory tract infections.In the male population,the total number of attributable deaths increased from 1,537,200 in 2010 to 1,798,100 in 2018.Stroke was the leading cause of death and mortality from smoking-related diseases,with 4241 thousand deaths in 2018,followed by tracheal,bronchial and lung cancer,and chronic obstructive pulmonary disease.Ischemic heart disease and esophageal cancer.In the female population,the total number of attributable deaths in 2018 was 264,800.The leading cause of death and mortality from smoking-related diseases was ischemic heart disease,with 76,800 deaths in 2018,followed by stroke,chronic obstructive pulmonary disease and tracheal,bronchial and lung cancer,as well as esophageal cancer.(2)The total mortality due to smoking increased from 233.86/100,000 in 2010 to 268.96/100,000 in 2018,while the male population increased from 405.17/100,000 in 2010 to 471.58/100,000 in 2018,and the female population increased from 60.21/100,000 in 2010 to 63.89 in 2018 From 2010 to 2018,the total attributable mortality of the above population showed an upward trend,while the standardized attributable mortality showed a downward trend.(3)Sichuan,Qinghai,Guizhou,Yunnan,Hunan and other provinces had the highest total mortality rate of male population.The lower provinces are Shanghai,Beijing,Hainan,Zhejiang and Jilin.Heilongjiang,Inner Mongolia,Liaoning,Shandong,Jilin and other provinces had the highest total mortality rate of female population.The lower provinces are Shanghai,Hainan,Fujian,Chongqing and Guangxi.For male and female,the provinces with higher total mortality rates were Heilongjiang,Inner Mongolia,Guizhou,Sichuan and Hunan.The lower provinces are Shanghai,Beijing,Hainan,Zhejiang and Fujian.ConclusionSmoking rates are higher among men than among women.The deaths attributed to smoking accounted for about 27%of the total cause of death in China,about 41%in males and 8%in females.Smoking caused a heavy death burden in China,reaching 2.242,900 people in 2018.The number of deaths attributable to smoking is much higher in men than in women.The leading causes of death from smoking are stroke,ischemic heart disease,COPD and lung cancer.As an important risk factor of chronic non-communicable diseases,smoking causes an extremely heavy disease burden and is a major public health problem in China.Provinces such as Guizhou,Sichuan and Hunan should take stronger measures to control tobacco use.Considering the differences among different groups,it is urgent to take targeted prevention and control measures in different groups to protect people’s health. |
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