Institute for Health Metrics and Evaluation, University of Washington, Seattle.
School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.
JAMA. 2014 Jan 8;311(2):183-92. doi: 10.1001/jama.2013.284692.
Tobacco is a leading global disease risk factor. Understanding national trends in prevalence and consumption is critical for prioritizing action and evaluating tobacco control progress.
To estimate the prevalence of daily smoking by age and sex and the number of cigarettes per smoker per day for 187 countries from 1980 to 2012.
Nationally representative sources that measured tobacco use (n = 2102 country-years of data) were systematically identified. Survey data that did not report daily tobacco smoking were adjusted using the average relationship between different definitions. Age-sex-country-year observations (n = 38,315) were synthesized using spatial-temporal gaussian process regression to model prevalence estimates by age, sex, country, and year. Data on consumption of cigarettes were used to generate estimates of cigarettes per smoker per day.
Modeled age-standardized prevalence of daily tobacco smoking by age, sex, country, and year; cigarettes per smoker per day by country and year.
Global modeled age-standardized prevalence of daily tobacco smoking in the population older than 15 years decreased from 41.2% (95% uncertainty interval [UI], 40.0%-42.6%) in 1980 to 31.1% (95% UI, 30.2%-32.0%; P < .001) in 2012 for men and from 10.6% (95% UI, 10.2%-11.1%) to 6.2% (95% UI, 6.0%-6.4%; P < .001) for women. Global modeled prevalence declined at a faster rate from 1996 to 2006 (mean annualized rate of decline, 1.7%; 95% UI, 1.5%-1.9%) compared with the subsequent period (mean annualized rate of decline, 0.9%; 95% UI, 0.5%-1.3%; P = .003). Despite the decline in modeled prevalence, the number of daily smokers increased from 721 million (95% UI, 700 million-742 million) in 1980 to 967 million (95% UI, 944 million-989 million; P < .001) in 2012. Modeled prevalence rates exhibited substantial variation across age, sex, and countries, with rates below 5% for women in some African countries to more than 55% for men in Timor-Leste and Indonesia. The number of cigarettes per smoker per day also varied widely across countries and was not correlated with modeled prevalence.
Since 1980, large reductions in the estimated prevalence of daily smoking were observed at the global level for both men and women, but because of population growth, the number of smokers increased significantly. As tobacco remains a threat to the health of the world's population, intensified efforts to control its use are needed.
烟草是全球主要的疾病风险因素。了解流行率和消费的国家趋势对于优先采取行动和评估烟草控制进展至关重要。
估计 1980 年至 2012 年 187 个国家按年龄和性别划分的每日吸烟流行率以及每个吸烟者每天的香烟数量。
系统地确定了衡量烟草使用情况的全国性来源（n=2102 个国家/年份的数据）。使用不同定义之间的平均关系，对未报告每日烟草使用情况的调查数据进行了调整。使用空间-时间高斯过程回归对年龄、性别、国家和年份的流行率估计值进行综合，以对年龄、性别、国家和年份的流行率进行建模。使用香烟消费数据生成每个吸烟者每天的香烟数量的估计值。
按年龄、性别、国家和年份建模的年龄标准化的每日烟草吸烟流行率；按国家和年份建模的每个吸烟者每天的香烟数量。
15 岁以上人群的全球模型年龄标准化的每日烟草吸烟流行率从 1980 年的 41.2%（95%置信区间[95%UI]，40.0%-42.6%）下降到 2012 年的 31.1%（95%UI，30.2%-32.0%；P<0.001），女性从 1980 年的 10.6%（95%UI，10.2%-11.1%）下降到 2012 年的 6.2%（95%UI，6.0%-6.4%；P<0.001）。与随后的时期（平均年化下降率为 0.9%；95%UI，0.5%-1.3%）相比，1996 年至 2006 年（平均年化下降率为 1.7%；95%UI，1.5%-1.9%）全球流行率的下降速度更快（P=0.003）。尽管流行率有所下降，但每日吸烟者的数量从 1980 年的 7.21 亿（95%UI，7.00 亿至 7.42 亿）增加到 2012 年的 9.67 亿（95%UI，9.44 亿至 9.89 亿；P<0.001）。在年龄、性别和国家方面，流行率存在很大差异，一些非洲国家的女性流行率低于 5%，而东帝汶和印度尼西亚的男性流行率超过 55%。每个吸烟者每天的香烟数量在各国之间也有很大差异，与模型预测的流行率无关。
自 1980 年以来，全球范围内男性和女性的每日吸烟流行率均大幅下降，但由于人口增长，吸烟者数量显著增加。由于烟草仍然对世界人口的健康构成威胁，因此需要加强控制其使用的力度。
