[Morbidity, mortality and the potential years of life lost attributable to tobacco]. / Morbilidad, mortalidad y años potenciales de vida perdidos atribuibles al tabaco.

BACKGROUND: The aim of this study was to evaluate the morbidity and mortality attributable to smoking. MATERIAL AND METHODS: A transversal study was performed in a reference population of residents of the province of Granada (Spain). The number of deaths in 1985, the number of patients admitted to public hospitals in 1987 and a sample of out patients in 1989 were gathered from the National Institute of Statistics and hospital registries, and a prospective collection from out patient clinics was also carried out. The diseases studied included: oropharyngeal, esophageal, pancreatic, laryngeal, lung, bladder and kidney carcinomas, ischemic cardiopathy, cerebrovascular stroke, peripheral arteriopathy and chronic obstructive lung disease (COPD). Statistical analysis was performed by populational etiologic fraction and the chi square test. RESULTS: Four point five percent of the total number of annual hospital admissions, 6.3% of the out patients, 15.9% of the mortality and 12.0% of the total number of potential years of life lost (TPYLL) were estimated to be attributable to smoking in individuals over the age of 15 years in the province of Granada. The most frequent causes of morbidity attributable to smoking were COPD and ischemic cardiopathy, and with regards to mortality, ischemic cardiopathy (28.5%), COPD (21.6%) and lung cancer (17.5%). Higher percentages were observed in males than in females and in the group from 46 to 65 years of age. CONCLUSIONS: Smoking is not only responsible for an important percentage of deaths, but also leads to premature death and a reduction in the quality of life which is translated into an excess of health care costs. Since the impact of smoking becomes particularly evident from 46 to 65 years of age, smoking prevention should be centered on the early years of life.

[Proportion of disease attributable to tobacco in the province of Granada]. / Proporción de enfermedad atribuible al tabaco en la provincia de Granada.

BACKGROUND: Smoking is the main cause of preventable morbidity and mortality in Europe. The effect of smoking is not constant with the diseases related to it. The goal of this study is to estimate poblational etiologic fractions (PEF), as the proportion of disease attributable to smoking in the reference population, for those disease clearly related to smoking in Granada. METHODS: The PEF depend upon relative risk (RR) and the proportion of exposed subjects in the target population. Meta-analytic procedures, following the Woolf's method, were applied to estimate weighted RR between smoking and each one of the diseases studied. A survey on a random sample of all Granadian population to assess the prevalence of smoking was performed. RESULTS: The PEF were always higher for males than for females. In males, the highest figures were for lung cancer (85%) and chronic obstructive lung disease (84%); whilst in females lung cancer and peripheral artery disease reached the greatest figures, 55% and 51%, respectively. CONCLUSIONS: The figures obtained outline the need for improving antismoking campaigns and allow to quantify the maximum potential benefit to be got if smoking was quit by the Granadian population.