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. 2024 Jan 26:15:1320033.
doi: 10.3389/fneur.2024.1320033. eCollection 2024.

Global burden of stroke attributable to secondhand smoke in 204 countries and territories from 1990 to 2019: analysis of the global burden of disease study

Xinyue Yang #  1 , Jiayi Sun #  1 , Wenjuan Zhang  1
Affiliations

Global burden of stroke attributable to secondhand smoke in 204 countries and territories from 1990 to 2019: analysis of the global burden of disease study

Xinyue Yang et al. Front Neurol. .

Abstract

Background: Secondhand smoke (SHS) continues a significant public health concern globally. This study aimed to assess the global burden of stroke attributable to SHS exposure during 1990-2019.

Methods: This analysis utilized data on stroke morbidity and mortality from the Global Burden of Disease (GBD) 2019 study covering 204 countries and territories. We estimated stroke burden indicators attributable to SHS exposure, including age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life-year rate (ASDR), stratified by age, sex, region, and stroke subtype.

Results: In 2019, global SHS exposure accounted for 2.01 [95% uncertainty interval (UI): 1.49-2.58] million stroke mortality. The ASMR and ASDR were 2.5 (95% UI: 1.9-3.2) and 61.5 (95% UI: 46-78.8) per 100,000 population, respectively. The disease burden was higher among women than men and higher among the elderly than younger populations. Intracerebral hemorrhage and ischemic stroke had a more significant burden than subarachnoid hemorrhage. From 1990 to 2019, the ASMR and ASDR declined [estimated annual percentage change: -2.08 (95% CI: -2.21% to -1.95%) and -2.08% (95% CI: -2.19% to -1.97%) for each], but the absolute number of mortalities increased along with population growth. Substantial disparities existed across regions and sociodemographic groups.

Conclusion: Despite declining ASMR and ASDR over time, the absolute number of stroke deaths attributable to SHS continued to rise globally, imposing a considerable stroke burden worldwide. These findings can inform targeted interventions and policies aimed at SHS control.

Keywords: global burden; health policy and planning; secondhand smoke; sociodemographic index; stroke.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Contribution of secondhand smoke to the absolute number of deaths from intracerebral hemorrhage, ischemic stroke, and subarachnoid hemorrhage globally and in various regions from 1990 to 2019.
Figure 2
Figure 2
Geographical variation in stroke burden attributed to secondhand smoke across 204 countries and territories. (A) The ASMR of stroke burden attributable to secondhand smoke in 2019. (B) The ASDR of stroke burden attributable to secondhand smoke in 2019. (C) The percentage change in stroke ASMR from 1990 to 2019. (D) The percentage change in stroke ASDR from 1990 to 2019. (E) The EAPC of stroke ASMR from 1990 to 2019. (F) The EAPC of stroke ASDR from 1990 to 2019. ASDR, age-standardized disability-adjusted life-year rate; ASMR, age-standardized mortality rate; EAPC, estimated annual percentage change.
Figure 3
Figure 3
Age-specific mortality (A) and DALYs (B) of stroke attributable to secondhand smoke by gender in 2019. DALY, disability-adjusted life years.
Figure 4
Figure 4
Age-standardized stroke death rates (A) and DALYs (B) attributed to secondhand smoke by SDI, 1990–2019. DALY, disability-adjusted life years.
Figure 5
Figure 5
Age-standardized rates of stroke death (A) and DALYs (B) attributable to secondhand smoke in 204 countries by SDI in 2019. DALY, disability-adjusted life years.
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