School of Nursing, Putian University, Putian, China.
School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Addiction. 2024 Apr;119(4):677-685. doi: 10.1111/add.16404. Epub 2023 Dec 17.
Smoking is a risk factor for low back pain (LBP) and rheumatoid arthritis (RA). We aimed to estimate the global health and economic burden of LBP and RA attributable to smoking.
This was a cross-sectional study.
The study was conducted in 192 countries and territories.
Prevalent cases of LBP and RA were used, extracted from the Global Burden of Diseases, Injuries and Risk Factors Study 2019 data repositories.
Smoking-attributable health and economic burden was estimated with the population-attributable fraction method. Smoking-attributable prevalence of LBP and RA and health-care costs were estimated for patients of all ages, whereas years lived with disability (YLDs) and productivity losses due to morbidity were estimated for patients aged 15-84 years. Uncertainty intervals (UIs) of the results were obtained by repeating the analysis with the lower and upper bounds of all input variables.
Globally, smoking accounted for 84.5 million (UI = 56.7-120.2 million) prevalent cases of LBP, 1.8 million (UI = 0.5-3.4 million) prevalent cases of RA and 11.3 million (UI = 6.2-18.5 million) YLDs, which represented 1.5% of all-cause YLDs in the working-age population aged 15-84 years in 2019. Health-care costs and productivity losses of smoking-attributable LBP and RA cost the global economy purchasing-power parity $326.0 billion (UI = $184.0-521.4 billion), representing 0.2% of the global gross domestic product. Specifically, smoking accounted for $65.8 billion (UI = $38.0-101.2 billion) in health-care costs world-wide, with more than half [$39.8 billion (UI = $23.1-61.3 billion), 60.6%] borne by the public sector. Smoking also contributed to $260.3 billion (UI = $146.0-420.3 billion) in productivity losses globally. Approximately 60.0% of the global YLDs were observed in middle-income countries, whereas 84.4% of health-care costs and 72.7% of productivity losses were borne by high-income countries.
Globally, in 2019, smoking accounted for more than 11.0 million years lived with disability and purchasing-power parity $326.0 billion in economic losses due to low back pain and rheumatoid arthritis. Middle-income countries suffered more morbidity, whereas high-income countries experienced larger economic losses.
吸烟是导致腰痛（LBP）和类风湿性关节炎（RA）的危险因素。我们旨在估计全球因吸烟而导致的 LBP 和 RA 的健康和经济负担。
这是一项横断面研究。
该研究在 192 个国家和地区进行。
从全球疾病、伤害和危险因素研究 2019 年数据存储库中提取 LBP 和 RA 的现患病例。
使用人群归因分数法估计与吸烟有关的健康和经济负担。对所有年龄段的患者估计了吸烟引起的 LBP 和 RA 的患病率和医疗保健费用，而对 15-84 岁患者估计了残疾造成的伤残年数（YLDs）和发病率导致的生产力损失。通过使用所有输入变量的下限和上限重复分析，获得结果的不确定区间（UI）。
全球范围内，吸烟导致 8450 万（UI=5670-12020 万）例腰痛现患病例、180 万（UI=0.5-340 万）例 RA 现患病例和 1130 万（UI=620-1850 万）例 YLDs，占 2019 年 15-84 岁劳动年龄人口所有原因 YLDs 的 1.5%。吸烟引起的 LBP 和 RA 的医疗保健费用和生产力损失使全球经济损失了 3260 亿美元（UI=1840-5214 亿美元），占全球国内生产总值的 0.2%。具体而言，全球范围内吸烟导致 658 亿美元（UI=380-1012 亿美元）的医疗保健费用，其中超过一半[398 亿美元（UI=231-613 亿美元），60.6%]由公共部门承担。吸烟还导致全球生产力损失 2603 亿美元（UI=1460-4203 亿美元）。大约 60.0%的全球 YLDs发生在中等收入国家，而 84.4%的医疗保健费用和 72.7%的生产力损失由高收入国家承担。
2019 年，全球范围内，吸烟导致超过 1100 万人因腰痛和类风湿性关节炎而丧失伤残调整寿命年数，经济损失达 3260 亿美元。中低收入国家的发病率较高，而高收入国家的经济损失较大。
