A new method for estimating smoking-attributable mortality in high-income countries

作者：Preston Samuel H; Glei Dana A^*; Wilmoth John R

来源：International Journal of Epidemiology, 2010, 39(2): 430-438.

DOI：10.1093/ije/dyp360

• Smoking
• mortality
• smoking
• mortality
• high-income populations
• lung neoplasms
• cause of death

Background Cigarette smoking is responsible for a massive loss of life in both developed and developing countries. This article develops an alternative to the Peto-Lopez method for estimating the number or fraction of smoking-attributable deaths in high-income countries.
Methods We use lung cancer death rates as an indicator of the damage caused by smoking. Using administrative data for the population aged >= 50 years from 20 high-income countries in the period from 1950 to 2006, we estimate a negative binomial regression model that predicts mortality from causes other than lung cancer as a function of lung cancer mortality and other variables. Using this regression model, we estimate smoking-attributable deaths based on the difference between observed death rates from lung cancer and expected rates among non-smokers.
Results Combining the estimated number of excess deaths from lung cancer with those from other causes, we find that among males in 1955 the smoking-attributable fraction was highest in Finland (18%); among women, no country exceeded 1%. By 2003, Hungary had the highest fraction of smoking-attributable deaths among males (32%), whereas the USA held that position among women (24%). Our estimates are remarkably similar to those produced by the Peto-Lopez method, a result that supports the validity of each approach.
Conclusions We provide a simple and straightforward method for estimating the proportion of deaths attributable to smoking in high-income countries. Our results demonstrate that smoking has played a central role in levels, trends and international differences in mortality over the past half century.

• 出版日期2010-4