Borges Margarida, Gouveia Miguel, Costa João, Dos Santos Pinheiro Luís, Paulo Sérgio, Vaz Carneiro António
Evidence-Based Medicine Centre for Studies, Lisbon University School of Medicine.
Rev Port Pneumol. 2009 Nov-Dec;15(6):951-1004.
The World Health Organization's (WHO) 2002 Annual Report estimated that about 14% of the burden of disease in wealthier countries is attributable to smoking. Smoking related diseases include cardiovascular diseases, cancer and respiratory diseases. This paper presents an estimate of the burden of disease attributable to smoking in Portugal. The estimates are based on the Portuguese demographic and health statistics available for 2005. The most important conclusion of the analysis is that 11.7% of deaths in Portugal are attributable to smoking. If we use disability adjusted life years (DALYs) to measure the burden of disease, we find that 11.2% of death DALYs in Portugal is attributable to smoking. The gender distribution of this amount is very unequal; 15.4% of the male burden of disease and 17.7% of all male deaths can be attributed to smoking, but only 4.9% of the female burden of disease and 5.2% of all female deaths. These estimates are higher than death estimates previously available (Peto et al. 2006); 14% in men and only 0.9% in women. This paper also presents estimates of the burden of reducible disease, that is, the reduction in mortality and DALYs that would occur if all current smokers quit and thus experienced the mean risk of ex-smokers, which is lower than for current smokers but typically not as low as for never-smokers. Our estimates are that the burden of disease would decrease by 5.8% (7.8% in men and 2.8% in women), and that deaths would decrease by 5.8% as well (with an 8.5% and 2.9% decrease in men and women, respectively). The paper also includes estimates of the burden of disease generated by smoking related disability. Smoking related illnesses generated 121,643 DALYs, 72,126 (59%) of which are attributable to smoking and 12,417 would be reducible if all smokers were to quit.
世界卫生组织（WHO）2002年年度报告估计，在较富裕国家中，约14%的疾病负担可归因于吸烟。与吸烟相关的疾病包括心血管疾病、癌症和呼吸系统疾病。本文给出了葡萄牙吸烟所致疾病负担的估计值。这些估计基于2005年可得的葡萄牙人口与健康统计数据。分析的最重要结论是，葡萄牙11.7%的死亡可归因于吸烟。如果我们使用伤残调整生命年（DALYs）来衡量疾病负担，会发现葡萄牙11.2%的死亡伤残调整生命年可归因于吸烟。这一负担的性别分布极不均衡；15.4%的男性疾病负担以及17.7%的男性死亡可归因于吸烟，但女性疾病负担中仅有4.9%，女性总死亡中仅有5.2%可归因于此。这些估计值高于此前可得的死亡估计值（Peto等人，2006年）；男性为14%，女性仅为0.9%。本文还给出了可避免疾病负担的估计值，即如果所有当前吸烟者戒烟并因此经历既往吸烟者的平均风险（低于当前吸烟者，但通常不像从不吸烟者那么低），死亡率和伤残调整生命年将会出现的降低情况。我们的估计是，疾病负担将降低5.8%（男性降低7.8%，女性降低2.8%），死亡也将降低5.8%（男性和女性分别降低8.5%和2.9%）。本文还包括了吸烟相关残疾所产生的疾病负担估计值。吸烟相关疾病产生了121,643个伤残调整生命年，其中72,126个（59%）可归因于吸烟，如果所有吸烟者戒烟，12,417个伤残调整生命年将可避免。
