1990-2021年中国吸烟所致慢性呼吸系统疾病负担分析与预测OA

Objective To analyze trends in the disease burden of chronic respiratory diseases(CRD)attributable to smoking in China from 1990 to 2021 and to project its development from 2022 to 2035,providing scientific evidence for optimizing tobacco control strategies and public health decision-making.Methods Using Global Burden of Disease(GBD)2021 data,epidemiological data on smoking-attributable CRD were collected for China,Japan,the European Union,the United States,and the global population from 1990 to 2021.Indicators included years lived with disability(YLDs),years of life lost(YLLs),and disability-adjusted life years(DALYs),covering individuals aged 30 years and older.Joinpoint regression models estimated average annual percentage changes(AAPCs),while Bayesian age-period-cohort(BAPC)models projected future trends.Results In 2021,smoking-attributable CRD DALYs in China reached 10 320 279(95%uncertainty interval[UI]:7 806 610-12 875 089)person-years,with an age-standardized disability-adjusted life years rate(ASDR)of 522.34(95%UI:394.50-653.32)per 100 000 person-years.The number of deaths was 566 446(95%UI:416 802-720 431),with an age-standardized mortality rate(ASMR)of 31.34(95%UI:23.10-39.69)per 100 000 population.YLLs and YLDs were 8 983 486(95%UI:6 547 449-11 421 727)person-years and 1 336 793(95%UI:981 768-1 699 656)person-years,corresponding to age-standardized rates(ASR)of 458.96(95%UI:337.53-582.19)per 100 000 person-years and 63.38(95%UI:46.17-80.72)per 100 000 person-years,respectively.The disease burden showed significant differences by gender and age,with higher risks among males and middle-aged and elderly populations.From 1990 to 2021,all burden indicators in China showed a declining trend,with ASMR and ASDR projected to continue decreasing over the next decade.Conclusion China has made positive progress in CRD prevention and tobacco control,but challenges such as population aging require continued attention.Targeted prevention interventions,particularly for high-risk populations,should be strengthened to reduce disease burden.The experience and challenges documented in China could offer valuable lessons and policy insights for other countries undergoing similar epidemiological transitions.