Tobacco Free Initiative, World Health Organization Regional Office for South-East Asia, New Delhi, Delhi, India.
Vanke School of Public Health, Tsinghua University, Beijing, China
Tob Control. 2024 Jun 20;33(4):425-433. doi: 10.1136/tc-2022-057669.
To describe the prevalence of smokeless tobacco (SLT) use and number of users by year, in addition to trends in mortality and attributable disease burden in countries of the WHO South-East Asia Region (SEAR), to inform policies for SLT control in the Region.
For each SEAR country, we obtained data from Global Adult Tobacco Surveys, WHO STEPwise Approach to NCD Risk Factor Surveillance surveys and Demographic and Health Surveys conducted since 2010 to estimate prevalence of SLT use by country, sex and year. Using data from the World Population Prospects database we estimated the number of users by country. Next, using the results of previous meta-analyses and prevalence results, we estimated the population attributable fractions and attributable mortality and morbidity in terms of annual deaths and disability-adjusted life years lost. We then characterised trends in attributable deaths and disease burden for countries with comparable data.
There were wide differences in SLT use prevalence by country. We estimated that, during 2015-2019, there were 165 803 900 SLT users across SEAR, with 479 466 attributable deaths annually of which India accounted for 79.9% with 383 248. Attributable annual deaths increased in some countries during 2015-2019.
Annual deaths and disease burden attributable to SLT remain high across SEAR and have only declined modestly in recent years. Effective implementation of all WHO Framework Convention on Tobacco Control measures, addressing both supply-side and demand-side issues, in relation to SLT and areca nut products must be prioritised to ensure reductions in mortality and disease burden are sustained and accelerated.
描述世界卫生组织东南亚区域（SEAR）国家无烟烟草（SLT）使用的流行率和用户数量，以及死亡率和归因疾病负担的趋势，为该区域的 SLT 控制政策提供信息。
对于每个 SEAR 国家，我们从全球成人烟草调查、世卫组织逐步方法进行非传染性疾病危险因素监测调查和 2010 年以来开展的人口与健康调查中获取数据，以估计国家、性别和年份的 SLT 使用流行率。我们使用世界人口展望数据库中的数据估计了每个国家的用户数量。接下来，我们使用之前荟萃分析的结果和流行率结果，估计了人口归因分数和归因于死亡率和残疾调整生命年损失的发病率。然后，我们根据具有可比数据的国家的归因死亡和疾病负担趋势进行了特征描述。
国家之间的 SLT 使用流行率存在很大差异。我们估计，在 2015-2019 年期间，SEAR 地区有 16580.39 万名 SLT 用户，每年有 47.9466 人归因死亡，其中印度占 79.9%，有 38.3248 人。在 2015-2019 年期间，一些国家的归因年度死亡人数有所增加。
SEAR 地区每年归因于 SLT 的死亡人数和疾病负担仍然很高，近年来仅略有下降。必须优先考虑有效实施世卫组织烟草控制框架公约的所有措施，解决 SLT 和槟榔产品的供应方和需求方问题，以确保死亡率和疾病负担的减少得以持续和加速。
