Global disease burden analysis of Cardiometabolic disease attributable to second-hand smoke exposure from 1990 to 2040

Abstract

Objective: Secondhand smoke (SHS) is a strong but comparatively controllable cardiometabolic risk factor. This study aims to assess the present and future burden of cardiometabolic diseases (CMDs) from SHS exposure.

Methods: Using the Global Burden of Disease (GBD) framework, we examined mortality and disability-adjusted life year (DALY) from CMDs attributable to SHS, by age, sex, and year, including cardiovascular disease [CVD, ischemic heart disease (IHD) and/or stroke], and/or Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019. The predicted death number and age-standardized mortality rate (ASMR) from 2020 to 2040 were estimated by the Bayesian age-period cohort (BAPC) model.

Results: SHS exposure declined until 2016 but stabilized or increased thereafter. From 1990 to 2019, CMD-related deaths and DALYs due to SHS are continuously increasing, particularly in low-middle and middle Sociodemographic Index (SDI) regions. In 2019, a significant proportion of CMD-related deaths and DALYs among females under 65 were attributed to SHS exposure. In females aged 25-29, SHS contributed to 16.12 % and 13.30 % of IHD and T2DM deaths, respectively. Surprisingly, forecasts show that annual deaths from IHD, stroke, and T2DM related to SHS exposure are anticipated to rise over the next 20 years.

Conclusions: SHS exposure has stopped declining in recent years. CMD-related deaths from controlled SHS have increased and are predicted to rise substantially over the next 20 years. Reducing SHS exposure could have major benefits for cardiometabolic health worldwide, especially for women under 65 years in less developed regions.

Keywords: Bayesian age-period-cohort; Cardiometabolic disease; Global disease burden; Second-hand smoke.

Central IIIustration: Global burden of Cardiometabolic disease attributable to second-hand smoke exposure

Fig. 1

The prevalence of secondhand smoke was grouped by sex, age, region, and country. A. The prevalence of secondhand smoke was grouped by sex. B. The prevalence of secondhand smoke was grouped by age. C. The prevalence of secondhand smoke was grouped by region. D. The prevalence of secondhand smoke was grouped by country.

Fig. 2

The burden of Cardiometabolic diseases caused by secondhand smoke grouped by sex from 1990 to 2019. DALY, disability-adjusted life year.

Fig. 3

Estimated Annual Percentage Change in different SDI regions. ASMR, age-standardized mortality rate. ASDR, age-standardized disability-adjusted life-year rate. SDI, Social Development Index EAPC, estimated annual percentage change.

Fig. 4

Spatial distribution of cardiovascular disease burden attributable to secondhand smoke in 204 Countries and Territories. ASMR, age-standardized mortality rate. ASDR, age-standardized disability-adjusted life-year rate. EAPC, estimated annual percentage change A. The global distribution of ASMRs of cardiovascular diseases attributable to secondhand smoke in 2019. B. The global distribution of ASDRs of cardiovascular diseases attributable to secondhand smoke in 2019. C. EAPCs in the ASMR of cardiovascular diseases attributable to secondhand smoke by country from 1990 to 2019. D. EAPCs in the ASDR of cardiovascular diseases attributable to secondhand smoke by country from 1990 to 2019.

Fig. 5

The proportion of Cardiometabolic diseases Deaths and DALYs attributable to secondhand smoke by sex and age in 2019. DALY, disability-adjusted life year.

Fig. 6

Prediction of cardiometabolic disease deaths burden from 2020 to 2040 caused by secondhand smoke global. ASMR: age-standardized mortality rate A. Prediction of CMD deaths caused by secondhand smoke by sex in global. B. Prediction of CMDs ASMR caused by secondhand smoke in females. C. Prediction of CMDs ASMR caused by secondhand smoke in males.