Mehta Dipal, Dennis Rory, Nallamilli Susanna, Vithayathil Mathew, Martínez-Sánchez Jose María
Department of Haematology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom.
Department of Anaesthetics, Mid Essex NHS Foundation Trust, Essex, United Kingdom.
Tob Prev Cessat. 2021 Apr 30;7:31. doi: 10.18332/tpc/133008. eCollection 2021.
To determine the correlation between tobacco control policies and mortality of haematological malignancies: leukemia, lymphoma and multiple myeloma (MM).
Ecological study with the countries as the unit of analysis. Tobacco Control Scale (TCS) scores from 2010, 2013 and 2016 were used as measures for the level of tobacco control policy implementation in 27 European countries. Mortality rates for leukemia, lymphoma, and MM, were obtained from the WHO Mortality Database and the European Cancer Information System for each country for 2010, 2013, 2015 and 2018. Correlation between yearly TCS scores and mortality rates from the same and prospective years were calculated using Spearman's rank correlation coefficients (r) and 95% confidence intervals (95% CI) (2010 TCS scores vs 2010, 2013, 2015, 2018 mortality rates; 2013 TCS scores vs 2013, 2015, 2018 mortality rates; and 2016 TCS scores vs 2018 mortality rates).
The 2010 TCS scores were significantly negatively associated with leukemia mortality rates in 2013 (r=-0.58; 95% CI: -0.79, -0.24; p=0.002), 2015 (r=-0.65; 95% CI: -0.85, -0.30; p=0.001) and 2018 (r=-0.44; 95% CI: -0.71, -0.06; p=0.021). TCS scores from 2013 and 2016 had significant negative associations with leukemia mortality in all prospective years. TCS scores did not demonstrate consistent correlations with lymphoma and MM mortality.
The level of tobacco control policies in European countries correlates negatively with leukemia mortality at ecological level, with no correlation seen for lymphoma and MM. This study advocates that increased tobacco control implementation may improve leukemia mortality.
确定烟草控制政策与血液系统恶性肿瘤（白血病、淋巴瘤和多发性骨髓瘤（MM））死亡率之间的相关性。
以国家为分析单位进行生态研究。2010年、2013年和2016年的烟草控制量表（TCS）得分被用作27个欧洲国家烟草控制政策实施水平的衡量指标。白血病、淋巴瘤和MM的死亡率数据来自世界卫生组织死亡率数据库以及2010年、2013年、2015年和2018年每个国家的欧洲癌症信息系统。使用Spearman等级相关系数（r）和95%置信区间（95%CI）计算年度TCS得分与同年及未来年份死亡率之间的相关性（2010年TCS得分与2010年、2013年、2015年、2018年死亡率；2013年TCS得分与2013年、2015年、2018年死亡率；以及2016年TCS得分与2018年死亡率）。
2010年TCS得分与2013年（r=-0.58；95%CI：-0.79，-0.24；p=0.002）、2015年（r=-0.65；95%CI：-0.85，-0.30；p=0.001）和2018年（r=-0.44；95%CI：-0.71，-0.06；p=0.021）的白血病死亡率显著负相关。2013年和2016年的TCS得分与所有未来年份的白血病死亡率均呈显著负相关。TCS得分与淋巴瘤和MM死亡率未显示出一致的相关性。
在生态层面，欧洲国家的烟草控制政策水平与白血病死亡率呈负相关，而与淋巴瘤和MM死亡率无相关性。本研究倡导加强烟草控制措施的实施可能会降低白血病死亡率。
