Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain
Centre d'Estudis Demogràfics, Centres de Recerca de Catalunya (CERCA), Universitat Autònoma de Barcelona, Bellaterra-Barcelona, Catalonia, Spain.
BMJ Open. 2022 Aug 10;12(8):e059370. doi: 10.1136/bmjopen-2021-059370.
To estimate smoking-related mortality and its contribution to educational inequalities in life expectancy in Spain.
Nationwide, observational study from 2016 to 2019. Population-attributable fractions were used to estimate age, sex and education-specific cause-of-death smoking-attributable mortality. Life table techniques and decomposition methods were used to estimate potential gains in life expectancy at age 35 and the cause-specific contributions of smoking-related mortality to life expectancy differences across educational groups.
Spain.
We use cause-specific mortality data from population registers and smoking prevalence from the National and the European Health Survey for Spain from 2017 and 2019/2020, respectively.
We estimated 219 086 smoking-related deaths during 2016-2019, equalling 13% of all deaths, 83.7% of those in men. In the absence of smoking, potential gains in male life expectancy were higher among the low-educated than the high-educated (3.1 vs 2.1 years). For women, educational differences were less and also in the opposite direction (0.6 vs 0.9 years). The contribution of smoking to life expectancy differences between high-educated and low-educated groups accounted for 1.5 years among men, and -0.2 years among women. For men, the contribution of smoking to these differences was mostly driven by cancer in middle age, cardiometabolic diseases at younger ages and respiratory diseases at older ages. For women, the contribution to this gap, although negligible, was driven by cancer at older ages among the higher educated.
Smoking remains a relevant preventable risk factor of premature mortality in Spain, disproportionately affecting life expectancy of low-educated men.
估计与吸烟相关的死亡率及其对西班牙预期寿命教育不平等的贡献。
2016 年至 2019 年全国观察性研究。使用人群归因分数来估计年龄、性别和教育特定的死因归因于吸烟的死亡率。寿命表技术和分解方法用于估计 35 岁时预期寿命的潜在增加以及吸烟相关死亡率对不同教育群体预期寿命差异的特定原因的贡献。
西班牙。
我们使用来自人口登记册的特定原因死亡率数据和 2017 年和 2019/2020 年全国和欧洲健康调查的西班牙吸烟流行率。
我们估计 2016-2019 年期间有 219086 例与吸烟相关的死亡，占所有死亡的 13%，其中 83.7%为男性。如果没有吸烟，低教育程度男性的预期寿命潜在增加高于高教育程度男性（3.1 年对 2.1 年）。对于女性，教育差异较小，方向相反（0.6 年对 0.9 年）。吸烟对高教育程度和低教育程度人群之间预期寿命差异的贡献在男性中占 1.5 年，在女性中占-0.2 年。对于男性，吸烟对这些差异的贡献主要归因于中年癌症、年轻时的心血管代谢疾病和老年时的呼吸系统疾病。对于女性，尽管这一差距可以忽略不计，但较高教育程度的女性老年时癌症对这一差距的贡献。
吸烟仍然是西班牙过早死亡的一个相关可预防风险因素，对低教育程度男性的预期寿命影响不成比例。
