Zhang Zhenhong, Wang Kai, Xu Guoxiang, Zhang Rumin
School of Clinical Medicine, Shandong Second Medical University, Weifang, People's Republic of China.
Department of Critical Care Medicine, Zibo Central Hospital, Zibo, People's Republic of China.
Tob Induc Dis. 2025 Feb 10;23. doi: 10.18332/tid/200196. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) poses a serious disease burden in China, and tobacco control is considered an effective and feasible means to reduce this burden. This study analyzes the impact of tobacco on the burden of COPD in China from 1990 to 2021.
This study conducted a comprehensive secondary dataset analysis of COPD attributable to tobacco in China using data from the Global Burden of Disease (GBD) database. This covers a range of statistics, including number of deaths, mortality rates, disability-adjusted life years (DALYs), and DALY rates. Using Joinpoint regression analysis methods, we calculated the annual percentage change (APC) and average annual percentage change (AAPC) to assess trends in COPD attributable to tobacco for various age groups and gender in China.
In 2021, the age-standardized mortality rate (ASMR) of COPD attributable to tobacco in China was 35.46 per 100000, and the age-standardized DALY rate (ASDR) was 589.75 per 100000, both of which were higher than global levels. In China, the ASMR attributable to tobacco showed a consistent decline from 1990 to 2021 (AAPC= -3.69%, p<0.001), as did the ASDR (AAPC= -3.73%, p<0.001), consistent with trends observed globally and across five SDI regions, with China experiencing the fastest decline. In both 1990 and 2021, the burden of COPD attributable to tobacco was greater in males compared to females. During the years from 1990 to 2021, the ASMR of COPD attributable to tobacco and the ASDR showed a declining trend in males (AAPC= -3.29% and -3.41%, respectively) and in females (AAPC= -4.99% and -4.62%, respectively) (all p<0.001). The impact of COPD linked to tobacco use in China increased with age from 1990 to 2021, with the highest mortality and DALY rates observed in the population aged ≥70 years. Regarding secondhand smoke exposure, ASMR for females was 6.29 per 100000 and the ASDR was 119.03 per 100000, while the corresponding values for males were 7.80 per 100000 and 113.10 per 100000 , indicating a higher burden among females.
From 1990 to 2021, the age-standardized mortality rate and age-standardized DALY rate of COPD attributable to tobacco in China showed a declining trend; however, there remains a slight gap compared to global levels. Significant differences in smoking exposure were observed based on gender and age, with a heavier burden among males and the elderly.
慢性阻塞性肺疾病（COPD）在中国造成了严重的疾病负担，而控烟被认为是减轻这一负担的有效且可行的手段。本研究分析了1990年至2021年烟草对中国COPD负担的影响。
本研究使用全球疾病负担（GBD）数据库的数据，对中国因烟草导致的COPD进行了全面的二次数据集分析。这涵盖了一系列统计数据，包括死亡人数、死亡率、伤残调整生命年（DALYs）和DALY率。使用Joinpoint回归分析方法，我们计算了年度百分比变化（APC）和平均年度百分比变化（AAPC），以评估中国不同年龄组和性别的因烟草导致的COPD趋势。
2021年，中国因烟草导致的COPD年龄标准化死亡率（ASMR）为每10万人35.46例，年龄标准化DALY率（ASDR）为每10万人589.75例，两者均高于全球水平。在中国，1990年至2021年期间，因烟草导致的ASMR呈持续下降趋势（AAPC = -3.69%，p<0.001），ASDR也是如此（AAPC = -3.73%，p<0.001），这与全球和五个社会人口指数（SDI）区域观察到的趋势一致，中国下降速度最快。在1990年和2021年，男性因烟草导致的COPD负担均高于女性。在1990年至2021年期间，男性（AAPC分别为-3.29%和-3.41%）和女性（AAPC分别为-4.99%和-4.62%）因烟草导致的COPD的ASMR和ASDR均呈下降趋势（所有p<0.001）。1990年至2021年期间，中国与烟草使用相关的COPD影响随年龄增长而增加，在≥70岁人群中观察到最高的死亡率和DALY率。关于二手烟暴露，女性的ASMR为每10万人6.29例，ASDR为每10万人119.03例，而男性的相应值分别为每10万人7.80例和113.10例，表明女性负担更高。
1990年至2021年，中国因烟草导致的COPD年龄标准化死亡率和年龄标准化DALY率呈下降趋势；然而，与全球水平相比仍存在细微差距。基于性别和年龄观察到吸烟暴露存在显著差异，男性和老年人负担更重。
