Zhu Shuaijie, Gao Jian, Zhang Liangliang, Dong Wanguo, Shi Wei, Guo Heng, Zhang Xiaoyu, Hua Tianfeng, Yang Min
Laboratory of Cardiopulmonary Resuscitation and Critical Illness, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
The Second Department of Critical Care Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Tob Induc Dis. 2025 Jan 31;23. doi: 10.18332/tid/200072. eCollection 2025.
Smoking poses a serious threat to cardiovascular health. The aim of the study is to evaluate the global, regional, and national burden of smoking-attributable cardiovascular disease (CVD) and set priorities for future tobacco control.
Data on deaths and years lived with disability (YLDs) for smoking-related CVD from 1990 to 2021, including age-standardized rates (ASRs), were sourced from the Global Burden of Disease (GBD) 2021. This study is a secondary descriptive analysis of the GBD 2021 data. We used the estimated annual percentage change (EAPC) to reflect temporal trends in disease burden and conducted a sensitivity analysis using the average annual percentage change (AAPC) to corroborate the findings. We also analyzed the relationship between disease burden and the Sociodemographic Index (SDI).
In 2021, smoking-related CVD caused 2.25 million deaths and 3.09 million YLDs globally, marking increases of 26.16% and 59.73% from 1990, respectively. However, from 1990 to 2021, the global age-standardized mortality rate (ASMR) and age-standardized years lived with disability rate (ASYR) for smoking-related CVDs decreased, with EAPCs of -1.94 and -0.92, respectively. Between 1990 and 2021, Australasia and Tropical Latin America experienced the largest declines in ASMR and ASYR, with EAPCs of -5.54 and -2.63, respectively, while Lesotho and Mali had the largest increases, with EAPCs of 2.68 and 1.67, respectively. Throughout the period, the burden of smoking-related CVD was consistently higher in men. Moreover, the trend of decline in disease burden was slower in men compared to women (EAPC for ASMR: -1.78 for men vs -3.25 for women). In 2021, countries with higher SDI also had higher ASYR.
Although the global burden of smoking-related CVD has declined over the past three decades, the challenge remains severe, particularly in less developed countries and regions. More proactive and effective tobacco control measures should be urgently implemented in countries where the burden of smoking-related CVD is severe.
吸烟对心血管健康构成严重威胁。本研究的目的是评估吸烟所致心血管疾病（CVD）的全球、区域和国家负担，并为未来的烟草控制确定优先事项。
1990年至2021年吸烟相关CVD的死亡数据和伤残调整生命年（YLDs）数据，包括年龄标准化率（ASRs），来源于《2021年全球疾病负担》（GBD 2021）。本研究是对GBD 2021数据的二次描述性分析。我们使用估计年度百分比变化（EAPC）来反映疾病负担的时间趋势，并使用平均年度百分比变化（AAPC）进行敏感性分析以证实研究结果。我们还分析了疾病负担与社会人口指数（SDI）之间的关系。
2021年，吸烟相关CVD在全球导致225万人死亡和309万伤残调整生命年，分别比1990年增加了26.16%和59.73%。然而，1990年至2021年，吸烟相关CVD的全球年龄标准化死亡率（ASMR）和年龄标准化伤残调整生命年率（ASYR）下降，EAPC分别为-1.94和-0.92。1990年至2021年期间，澳大拉西亚和热带拉丁美洲的ASMR和ASYR下降幅度最大，EAPC分别为-5.54和-2.63，而莱索托和马里的增幅最大，EAPC分别为2.68和1.67。在整个时期，吸烟相关CVD的负担在男性中一直较高。此外，男性疾病负担的下降趋势比女性慢（ASMR的EAPC：男性为-1.78，女性为-3.25）。2021年，SDI较高的国家也有较高的ASYR。
尽管过去三十年吸烟相关CVD的全球负担有所下降，但挑战仍然严峻，特别是在欠发达国家和地区。在吸烟相关CVD负担严重的国家，应紧急实施更积极有效的烟草控制措施。
