TY - JOUR
T1 - Forecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050
T2 - a systematic analysis for the Global Burden of Disease Study 2021
AU - GBD 2021 Tobacco Forecasting Collaborators
AU - Bryazka, Dana
AU - Reitsma, Marissa B.
AU - Abate, Yohannes Habtegiorgis
AU - Abd Al Magied, Abdallah H.A.
AU - Abdelkader, Atef
AU - Abdollahi, Arash
AU - Abdoun, Meriem
AU - Abdulkader, Rizwan Suliankatchi
AU - Abeldaño Zuñiga, Roberto Ariel
AU - Abhilash, E. S.
AU - Abiodun, Olugbenga Olusola
AU - Abiodun, Olumide
AU - Aboagye, Richard Gyan
AU - Abreu, Lucas Guimarães
AU - Abtahi, Dariush
AU - Abualruz, Hasan
AU - Abubakar, Bilyaminu
AU - Abu-Rmeileh, Niveen ME
AU - Aburuz, Salahdein
AU - Abu-Zaid, Ahmed
AU - Adane, Mesafint Molla
AU - Adebiyi, Akindele Olupelumi
AU - Adegboye, Oyelola A.
AU - Adekanmbi, Victor
AU - Adewuyi, Habeeb Omoponle
AU - Adnani, Qorinah Estiningtyas Sakilah
AU - Adzigbli, Leticia Akua
AU - Afaghi, Siamak
AU - Afolabi, Aanuoluwapo Adeyimika
AU - Afzal, Muhammad Sohail
AU - Afzal, Saira
AU - Agodi, Antonella
AU - Agyemang-Duah, Williams
AU - Ahinkorah, Bright Opoku
AU - Ahlstrom, Austin J.
AU - Ahmad, Aqeel
AU - Ahmad, Danish
AU - Ahmad, Muayyad M.
AU - Ahmad, Sajjad
AU - Ahmad, Shahzaib
AU - Ahmadi, Ali
AU - Ahmed, Anisuddin
AU - Ahmed, Ayman
AU - Ahmed, Haroon
AU - Ahmed, Muktar Beshir
AU - Ahmed, Safoora
AU - Ajami, Marjan
AU - Akkaif, Mohammed Ahmed
AU - Akter, Ema
AU - Trihandini, Indang
N1 - Publisher Copyright:
© 2024 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license
PY - 2024/10
Y1 - 2024/10
N2 - Background: Smoking is the leading behavioural risk factor for mortality globally, accounting for more than 175 million deaths and nearly 4·30 billion years of life lost (YLLs) from 1990 to 2021. The pace of decline in smoking prevalence has slowed in recent years for many countries, and although strategies have recently been proposed to achieve tobacco-free generations, none have been implemented to date. Assessing what could happen if current trends in smoking prevalence persist, and what could happen if additional smoking prevalence reductions occur, is important for communicating the effect of potential smoking policies. Methods: In this analysis, we use the Institute for Health Metrics and Evaluation's Future Health Scenarios platform to forecast the effects of three smoking prevalence scenarios on all-cause and cause-specific YLLs and life expectancy at birth until 2050. YLLs were computed for each scenario using the Global Burden of Disease Study 2021 reference life table and forecasts of cause-specific mortality under each scenario. The reference scenario forecasts what could occur if past smoking prevalence and other risk factor trends continue, the Tobacco Smoking Elimination as of 2023 (Elimination-2023) scenario quantifies the maximum potential future health benefits from assuming zero percent smoking prevalence from 2023 onwards, whereas the Tobacco Smoking Elimination by 2050 (Elimination-2050) scenario provides estimates for countries considering policies to steadily reduce smoking prevalence to 5%. Together, these scenarios underscore the magnitude of health benefits that could be reached by 2050 if countries take decisive action to eliminate smoking. The 95% uncertainty interval (UI) of estimates is based on the 2·5th and 97·5th percentile of draws that were carried through the multistage computational framework. Findings: Global age-standardised smoking prevalence was estimated to be 28·5% (95% UI 27·9–29·1) among males and 5·96% (5·76–6·21) among females in 2022. In the reference scenario, smoking prevalence declined by 25·9% (25·2–26·6) among males, and 30·0% (26·1–32·1) among females from 2022 to 2050. Under this scenario, we forecast a cumulative 29·3 billion (95% UI 26·8–32·4) overall YLLs among males and 22·2 billion (20·1–24·6) YLLs among females over this period. Life expectancy at birth under this scenario would increase from 73·6 years (95% UI 72·8–74·4) in 2022 to 78·3 years (75·9–80·3) in 2050. Under our Elimination-2023 scenario, we forecast 2·04 billion (95% UI 1·90–2·21) fewer cumulative YLLs by 2050 compared with the reference scenario, and life expectancy at birth would increase to 77·6 years (95% UI 75·1–79·6) among males and 81·0 years (78·5–83·1) among females. Under our Elimination-2050 scenario, we forecast 735 million (675–808) and 141 million (131–154) cumulative YLLs would be avoided among males and females, respectively. Life expectancy in 2050 would increase to 77·1 years (95% UI 74·6–79·0) among males and 80·8 years (78·3–82·9) among females. Interpretation: Existing tobacco policies must be maintained if smoking prevalence is to continue to decline as forecast by the reference scenario. In addition, substantial smoking-attributable burden can be avoided by accelerating the pace of smoking elimination. Implementation of new tobacco control policies are crucial in avoiding additional smoking-attributable burden in the coming decades and to ensure that the gains won over the past three decades are not lost. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
AB - Background: Smoking is the leading behavioural risk factor for mortality globally, accounting for more than 175 million deaths and nearly 4·30 billion years of life lost (YLLs) from 1990 to 2021. The pace of decline in smoking prevalence has slowed in recent years for many countries, and although strategies have recently been proposed to achieve tobacco-free generations, none have been implemented to date. Assessing what could happen if current trends in smoking prevalence persist, and what could happen if additional smoking prevalence reductions occur, is important for communicating the effect of potential smoking policies. Methods: In this analysis, we use the Institute for Health Metrics and Evaluation's Future Health Scenarios platform to forecast the effects of three smoking prevalence scenarios on all-cause and cause-specific YLLs and life expectancy at birth until 2050. YLLs were computed for each scenario using the Global Burden of Disease Study 2021 reference life table and forecasts of cause-specific mortality under each scenario. The reference scenario forecasts what could occur if past smoking prevalence and other risk factor trends continue, the Tobacco Smoking Elimination as of 2023 (Elimination-2023) scenario quantifies the maximum potential future health benefits from assuming zero percent smoking prevalence from 2023 onwards, whereas the Tobacco Smoking Elimination by 2050 (Elimination-2050) scenario provides estimates for countries considering policies to steadily reduce smoking prevalence to 5%. Together, these scenarios underscore the magnitude of health benefits that could be reached by 2050 if countries take decisive action to eliminate smoking. The 95% uncertainty interval (UI) of estimates is based on the 2·5th and 97·5th percentile of draws that were carried through the multistage computational framework. Findings: Global age-standardised smoking prevalence was estimated to be 28·5% (95% UI 27·9–29·1) among males and 5·96% (5·76–6·21) among females in 2022. In the reference scenario, smoking prevalence declined by 25·9% (25·2–26·6) among males, and 30·0% (26·1–32·1) among females from 2022 to 2050. Under this scenario, we forecast a cumulative 29·3 billion (95% UI 26·8–32·4) overall YLLs among males and 22·2 billion (20·1–24·6) YLLs among females over this period. Life expectancy at birth under this scenario would increase from 73·6 years (95% UI 72·8–74·4) in 2022 to 78·3 years (75·9–80·3) in 2050. Under our Elimination-2023 scenario, we forecast 2·04 billion (95% UI 1·90–2·21) fewer cumulative YLLs by 2050 compared with the reference scenario, and life expectancy at birth would increase to 77·6 years (95% UI 75·1–79·6) among males and 81·0 years (78·5–83·1) among females. Under our Elimination-2050 scenario, we forecast 735 million (675–808) and 141 million (131–154) cumulative YLLs would be avoided among males and females, respectively. Life expectancy in 2050 would increase to 77·1 years (95% UI 74·6–79·0) among males and 80·8 years (78·3–82·9) among females. Interpretation: Existing tobacco policies must be maintained if smoking prevalence is to continue to decline as forecast by the reference scenario. In addition, substantial smoking-attributable burden can be avoided by accelerating the pace of smoking elimination. Implementation of new tobacco control policies are crucial in avoiding additional smoking-attributable burden in the coming decades and to ensure that the gains won over the past three decades are not lost. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation.
UR - http://www.scopus.com/inward/record.url?scp=85205509483&partnerID=8YFLogxK
U2 - 10.1016/S2468-2667(24)00166-X
DO - 10.1016/S2468-2667(24)00166-X
M3 - Article
C2 - 39366729
AN - SCOPUS:85205509483
SN - 2468-2667
VL - 9
SP - e729-e744
JO - The Lancet Public Health
JF - The Lancet Public Health
IS - 10
ER -