Search

Introduction: Tobacco smoking poses a significant risk for various diseases, including cardiovascular diseases, chronic respiratory diseases, and cancers. In Kenya, tobacco-related deaths contribute substantially to non-communicable disease mortality. This study aims to quantify the mortality attributed to tobacco smoking in Kenya from 2012 to 2021. Methods: Employing a prevalence-based analysis model, the study utilized population attributable fraction (PAF) to estimate age-specific smoke attributable mortality (SAM) rates for individuals aged ≥35 years. Causes of death associated with tobacco use, including cancers, cardiovascular diseases, respiratory diseases, tuberculosis, and diabetes, were analyzed based on age, sex, and death records between 2012 and 2021. Results: Over the study period, 60228 deaths were attributed to tobacco-related diseases, with an annual increase observed until 2016 and subsequent fluctuations. Respiratory diseases, diabetes mellitus, malignant cancers, tuberculosis, and cardiovascular diseases collectively accounted for 16.5% of deaths among individuals aged ≥35 years. Notable contributors were pneumonia and influenza (respiratory diseases), esophageal cancer (cancers), and cerebrovascular diseases (cardiovascular diseases). Of the observed deaths, 16.5% were attributed to smoking, with respiratory diseases (40.5%), malignant cancers (31.4%), tuberculosis (13%), cardiovascular diseases (8.9%), and diabetes mellitus (6.1%) contributing. Pneumonia and influenza, esophageal cancer, chronic airway obstruction, and tuberculosis were primary causes, comprising 70% of all SAM. Conclusions: Tobacco-related mortality is a significant public health concern in Kenya. Efforts should focus on preventing tobacco use and managing associated disease burdens. Smoking cessation initiatives and comprehensive tobacco control measures are imperative to mitigate the impact on population health. [ABSTRACT FROM AUTHOR]

Background: Smoking is one of the leading causes of preventable mortality and morbidity worldwide, with the European Region having the highest prevalence of tobacco smoking among adults compared to other WHO regions. The Belgian Health Interview Survey (BHIS) provides a reliable source of national and regional estimates of smoking prevalence; however, currently there are no estimates at a smaller geographical resolution such as the municipality scale in Belgium. This hinders the estimation of the spatial distribution of smoking attributable mortality at small geographical scale (i.e., number of deaths that can be attributed to tobacco). The objective of this study was to obtain estimates of smoking prevalence in each Belgian municipality using BHIS and calculate smoking attributable mortality at municipality level.Methods: Data of participants aged 15 + on smoking behavior, age, gender, educational level and municipality of residence were obtained from the BHIS 2018. A Bayesian hierarchical Besag-York-Mollie (BYM) model was used to model the logit transformation of the design-based Horvitz-Thompson direct prevalence estimates. Municipality-level variables obtained from Statbel, the Belgian statistical office, were used as auxiliary variables in the model. Model parameters were estimated using Integrated Nested Laplace Approximation (INLA). Deviance Information Criterion (DIC) and Conditional Predictive Ordinate (CPO) were computed to assess model fit. Population attributable fractions (PAF) were computed using the estimated prevalence of smoking in each of the 589 Belgian municipalities and relative risks obtained from published meta-analyses. Smoking attributable mortality was calculated by multiplying PAF with age-gender standardized and stratified number of deaths in each municipality.Results: BHIS 2018 data included 7,829 respondents from 154 municipalities. Smoothed estimates for current smoking ranged between 11% [Credible Interval 3;23] and 27% [21;34] per municipality, and for former smoking between 4% [0;14] and 34% [21;47]. Estimates of smoking attributable mortality constituted between 10% [7;15] and 47% [34;59] of total number of deaths per municipality.Conclusions: Within-country variation in smoking and smoking attributable mortality was observed. Computed estimates should inform local public health prevention campaigns as well as contribute to explaining the regional differences in mortality. [ABSTRACT FROM AUTHOR]

Background: While Italy has implemented some tobacco control policies over the last few decades, which resulted in a decreased smoking prevalence, there is still considerable scope to strengthen tobacco control policies consistent with the World Health Organization (WHO) policy guidelines. The present study aims to evaluate the effect of past and project the effect of future tobacco control policies on smoking prevalence and associated premature mortality in Italy. Methods: To assess, individually and in combination, the effect of seven types of policies, we used the SimSmoke simulation model of tobacco control policy. The model uses population, smoking rates and tobacco control policy data for Italy. Results: Significant reductions of smoking prevalence and premature mortality can be achieved through tobacco price increases, high intensity media campaigns, comprehensive cessation treatment program, strong health warnings, stricter smoke-free air regulations and advertising bans, and youth access laws. With a comprehensive approach, the smoking prevalence can be decreased by as much as 12% soon after the policies are in place, increasing to a 30% reduction in the next twenty years and a 34% reduction by 30 years in 2040. Without effective tobacco control policies, a total of almost 300 thousand lives will be prematurely lost due to smoking by the year 2040. Conclusion: Besides presenting the benefits of a comprehensive tobacco control strategy, the model helps identify information gaps in surveillance and evaluation schemes that will promote the effectiveness of future tobacco control policy in Italy. [ABSTRACT FROM AUTHOR]

Background: The US Centres for Disease Control provides a widely used online user-friendly computational program, called SAMMEC (Smoking Attributable Mortality, Morbidity and Economic Costs) to produce estimates of tobacco-related mortality. However, the SAMMEC tool loses accuracy because it lacks flexibility in deciding which diseases enter into the calculations, has estimates of relative risk (RR) attributable to smoking based on old studies, and does not allow for the latency period that occurs between initial exposure and mortality. Methods: Smoking attributable mortality (SAM) due to active smoking in Israel was estimated with the approach used by SAMMEC taking into account past and present smoking prevalence (lag-times) as well as using new and expanded disease categories. Results: Around 50.3% of the increase from the un-lagged SAM estimate of 3859 deaths to the final SAM estimate of 8664 deaths in 2003 is attributable to the introduction of lag times. More robust estimates of risk accounted for a further 29.6% of the increase. While 21.2% is attributable to the inclusion of additional disease categories, only 1.5% was attributable to the widening of existing diseases categories. Conclusion: This difference in estimates is attributable to expansion of the list of diseases included, updating the estimates of RR for smoking-attributable death, and the use of smoking prevalence from previous years to more accurately reflect the effect of tobacco use on disease occurrence. There is a need to establish an ‘authority’ to implement a multi-faceted intervention strategy to decrease the considerable burden from smoking in Israel. [ABSTRACT FROM PUBLISHER]

This study examined mortality attributed to active and passive smoking in Taiwan for the years 1981 and 1990. It was estimated that 19, 283 deaths, representing 19% of the total number of deaths in 1990 (almost one out of five deaths in Taiwan), were smoking related. On an average day, 53 people died as a result of cigarette smoking, including 13 deaths from passive smoking. More men died (14, 140 deaths) from smoking-related causes than from all cancer deaths combined (13, 161 deaths); 91% of lung cancer and 30% of all cancers were due to smoking. In comparison, the smoking attributable mortality was much less for women, with 5, 143 deaths. In addition, almost 5, 000 deaths can be attributed to passive smoking every year in Taiwan with more deaths from women than from men. The overall prevalence rates for cigarette smoking has changed little in the last 20 years; approximately 60% for men and 4% for women although a consistent increase of one million new smokers was added every decade. Among younger people, the rate increased substantially, while it dropped 10-15% among middle-aged and older persons. Smoking is the largest single source of health risk in Taiwan. It is crucial that strategies to prevent smoking initiation among young people be developed so that the most vulnerable group can receive immediate attention. Despite the recent aggressive smoking cessation campaign by the Department of Health, much work remains. In order to facilitate this work, it is therefore recommended that the government commit to a goal of a smoke-free nation by the year 2010. Asia Pac J Public Health1994;7(4):206-13. [ABSTRACT FROM PUBLISHER]