[Attributable mortality to tobacco consumption in Brazil, 1996-2019]. / Mortalidad atribuida al consumo de tabaco en Brasil, 1996-2019.

OBJECTIVE: To analyze the burden of tobacco consumption on mortality and years of life expectancy lost in population ≥35 years in Brazil in the period 1996-2019 and to identify trend changes in smoking-attributable mortality. METHOD: An independent prevalence method using the lung cancer mortality rate as a proxy for cumulative smoking risk was used to estimate smoking-attributable mortality. Smoking-attributable mortality is estimated from the lung cancer mortality rate and applying relative risks from 5 US cohorts. Smoking-attributable mortality, crude and standardized attributed mortality rates are presented overall, by sex, age and causes of death. Trend analysis was performed by applying joinpoint regression models. Years of life expectancy lost due to tobacco were calculated. RESULTS: Tobacco consumption caused 2,389,831 deaths in Brazil between 1996-2019. Cardiometabolic diseases were the leading cause of death in women throughout the period and in men until 2015. Since 2006, smoking-attributable mortality rates in men, regardless of age, show a decreasing trend while in females the evolution is different. The years of life expectancy lost show a slight decrease since the first triennia and are higher in men. CONCLUSIONS: In Brazil, the 8.5% of total mortality between 1996-2019 is attributed to tobacco consumption. It is important to monitor the burden of the tobacco consumption on mortality in order to strengthen or implement interventions against smoking in Brazil.

Mortalidad atribuida al consumo de tabaco en Brasil, 1996-2019 / Attributable mortality to tobacco consumption in Brazil, 1996-2019

Objetivo: Analizar la carga del consumo de tabaco en la mortalidad y en los años de esperanza de vida perdidos en población ≥35 años en Brasil en el periodo 1996-2019, e identificar cambios de tendencia en la mortalidad atribuida. Método: Para estimar la mortalidad atribuida se aplicó un método independiente de prevalencia que asume la tasa de mortalidad por cáncer de pulmón como indicador indirecto del riesgo acumulado asociado al consumo de tabaco. La mortalidad atribuida se estima a partir de la tasa de mortalidad por cáncer de pulmón y aplicando riesgos relativos de cinco cohortes estadounidenses. Se presentan la mortalidad atribuida, las tasas de mortalidad atribuida brutas y estandarizadas en global, por sexo, edad y causas de muerte. Se analizó la tendencia aplicando modelos de regresión joinpoint. Se calcularon los años de esperanza de vida perdidos a causa del tabaco. Resultados: Entre 1996 y 2019 el consumo de tabaco causó 2.389.831 muertes en Brasil. Las enfermedades cardiometabólicas fueron la primera causa de muerte en mujeres en todo el periodo y en hombres hasta 2015. Desde 2006, las tasas de mortalidad atribuida en los hombres, con independencia de la edad, muestran una tendencia decreciente, mientras que en las mujeres la evolución es diferente. Los años de esperanza de vida perdidos muestran un ligero descenso desde los primeros trienios y son más en los hombres. Conclusiones: El 8,5% de la mortalidad total en Brasil durante el periodo 1996-2019 se atribuye al consumo de tabaco. Es importante monitorizar la carga del consumo de tabaco en la mortalidad para fortalecer o implantar intervenciones frente al tabaquismo en Brasil. (AU)

Objective: To analyze the burden of tobacco consumption on mortality and years of life expectancy lost in population ≥35 years in Brazil in the period 1996-2019 and to identify trend changes in smoking-attributable mortality. Method: An independent prevalence method using the lung cancer mortality rate as a proxy for cumulative smoking risk was used to estimate smoking-attributable mortality. Smoking-attributable mortality is estimated from the lung cancer mortality rate and applying relative risks from 5 US cohorts. Smoking-attributable mortality, crude and standardized attributed mortality rates are presented overall, by sex, age and causes of death. Trend analysis was performed by applying joinpoint regression models. Years of life expectancy lost due to tobacco were calculated. Results: Tobacco consumption caused 2,389,831 deaths in Brazil between 1996-2019. Cardiometabolic diseases were the leading cause of death in women throughout the period and in men until 2015. Since 2006, smoking-attributable mortality rates in men, regardless of age, show a decreasing trend while in females the evolution is different. The years of life expectancy lost show a slight decrease since the first triennia and are higher in men. Conclusions: In Brazil, the 8.5% of total mortality between 1996-2019 is attributed to tobacco consumption. It is important to monitor the burden of the tobacco consumption on mortality in order to strengthen or implement interventions against smoking in Brazil. (AU)