Kaur Jagdish, Rinkoo Arvind Vashishta, Richardson Sol
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 8. doi: 10.1136/tc-2024-058599.
The WHO South-East Asia Region is home to around 33% of adult tobacco users. To inform tobacco control policy and practice, we conducted a study using the latest available data to update mortality attributable to overall tobacco use, including smoked tobacco, smokeless tobacco (SLT) and secondhand smoke (SHS) exposure, in the 11 countries of the Region.
We estimated smoking, SLT use and SHS exposure using the latest available surveys for each country during 2016-2021, and then estimated all-cause and lung cancer-attributable annual deaths for each using the population-attributable fraction method. Finally, we estimated the annual total tobacco-attributable deaths including all three exposures using the multiplicative aggregation method.
We estimated the occurrence of 4 087 920 all-cause deaths and 105 279 lung cancer deaths annually attributable to tobacco use among the 11 countries investigated. India accounted for 63.9% of all-cause tobacco-attributable deaths.
The high annual number of tobacco-attributable deaths in the Region highlights the need for accelerating progress in reducing tobacco use. Implementation of the WHO Framework Convention on Tobacco Control (FCTC) and MPOWER policy package needs prioritisation at the country level. Tobacco cessation services, supply-side measures and policies to counter tobacco industry interference should be strengthened. Further work is needed to monitor progress towards FCTC implementation and analyse the impacts of policies on tobacco-related outcomes, including attributable mortality and disease burden, to inform advocacy efforts.
世界卫生组织东南亚区域约有33%的成年烟草使用者。为了为烟草控制政策和实践提供信息，我们开展了一项研究，利用现有最新数据更新该区域11个国家因总体烟草使用（包括吸烟、无烟烟草和二手烟暴露）导致的死亡率。
我们利用2016 - 2021年期间各国的最新调查数据估算吸烟、无烟烟草使用和二手烟暴露情况，然后使用人群归因分数法估算每种情况导致的全因死亡和肺癌归因年度死亡人数。最后，我们使用乘法汇总法估算包括所有三种暴露情况在内的年度烟草归因总死亡人数。
我们估算在接受调查的11个国家中，每年因烟草使用导致4087920例全因死亡和105279例肺癌死亡。印度占全因烟草归因死亡人数的63.9%。
该区域每年因烟草导致的死亡人数众多，凸显了加快减少烟草使用进展的必要性。在国家层面需要优先实施《世界卫生组织烟草控制框架公约》（FCTC）和MPOWER政策包。应加强戒烟服务、供应方措施以及应对烟草行业干扰的政策。需要进一步开展工作，监测《烟草控制框架公约》实施进展，并分析政策对烟草相关结果（包括归因死亡率和疾病负担）的影响，以为宣传工作提供信息。
