2013年中国居民吸烟对归因死亡和期望寿命的影响

摘要

目的 分析2013年我国吸烟的归因死亡和对期望寿命的影响.方法 利用2013年死因监测数据和慢性病及其危险因素监测数据,针对不同疾病特点,将以现在吸烟率作为暴露水平的直接法和以吸烟影响比作为暴露水平的间接法相结合,计算吸烟导致不同疾病死亡的人群归因分值,从而估计吸烟对于死亡和期望寿命的影响.结果 2013年中国人群由于吸烟导致约159.33万人死亡,占总死亡人数的17.38％,其中男性吸烟导致的死亡占比(23.66％)远远高于女性(8.30％),城市人群吸烟导致的死亡占比(17.24％)略低于农村人群(17.51％),东部地区人群吸烟导致的死亡占比最低(16.81％),西部地区最高(17.91％).2013年中国人群吸烟导致死亡人数在前三位的疾病是肺癌、COPD和缺血性心脏病,吸烟导致死亡归因分值最大的前三位疾病是肺癌、COPD和鼻咽癌.2013年中国人群吸烟导致期望寿命损失2.04岁,其中最高的为西部地区男性,共损失3.05岁.结论 吸烟仍是我国重要的公共卫生问题,针对重点地区人群开展控烟工作,可以降低吸烟相关疾病的死亡,有效地提高我国人群健康水平.%Objective To analyze the death attributable to smoking and impact of life expectancy in China in 2013.Methods According to the characteristics of different diseases,we calculated the population attributable fractions of different diseases,death and impact of life expectancy which caused by smoking,using direct method (current smoking rate as exposure levels)and indirect method (smoking impact ratio as exposure levels),based on data from both programs of death surveillance and Chinese chronic disease risk factor surveillance of 2013.Results In 2013,smoking caused around 1.59 million deaths which accounted for 17.38％ of all deaths in China.Constituent ratio of death caused by smoking in males (23.66％) was much higher than that in females (8.30％).However,in urban areas (17.24％),it was slightly lower than that in rural areas (17.51％).Constituent ratio of death caused by smoking in the eastern regions appeared the lowest (16.81％),with western regions the highest (17.91％).In 2013,lung cancer,COPD and ischemia heart disease were the top three diseases causing deaths that related to smoking,but the top three population attributable fractions were lung cancer,COPD and nasopharyngeal carcinoma in China.In 2013,smoking caused a reduction of 2.04 years of life expectancy loss in China,with males in the western regions the highest (3.05 years).Conclusion Smoking is still an important public health problem in China.Tobacco-control-targeted programs in the heavily involved areas could reduce the number of deaths from related diseases that caused by smoking.