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Objective <p>This study aims to analyze global trends in cancer deaths and disability-adjusted life years (DALYs) attributable to smoking from 1990 to 2021 using the Global Burden of Disease (GBD) database, and to predict trends over the next 20 years.</p> Methods <p>This study utilized the 2021 GBD database to extract annual mortality, DALYs, and age-standardized rates for cancer attributable to smoking across 204 countries from 1990 to 2021. Joinpoint regression assessed temporal trends, calculating average annual percentage change (AAPC). Autoregressive Integrated Moving Average (ARIMA) modeling forecasted future disease burden for 20 years.</p> Results <p>From 1990 to 2021, global cancer attributable to smoking deaths and DALYs increased, with deaths rising from 1,328.88 to 2,012.85 thousand and DALYs from 35,581.64 to 47,976.55 thousand, despite declining age-standardized mortality (ASMR) from 33.76 to 23.31 per 100,000 (AAPC: -1.19) and DALYs (ASDR) from 863.94 to 546.86 per 100,000 (AAPC: -1.47). Males exhibited a higher burden, with ASMR at 42.68 and ASDR at 978.15 per 100,000 in 2021, compared to females (7.01 and 161.30). High Socio-demographic Index (SDI) regions showed the steepest ASMR decline (AAPC: -1.80). Tracheal, bronchus, and lung, esophageal, and stomach cancers dominated the burden. In 2021, specific regions within Greenland, Eastern Europe, Central Asia, East Asia, and the Middle East demonstrated notably higher compared to other regions. The ARIMA model predicts that the ASMR and ASDR for cancer attributable to smoking in both males and females will continue to decline from 2022 to 2041.</p> Conclusion <p>This study reveals a rising global burden of cancer attributable to smoking deaths and DALYs. However, ASMR and ASDR have decreased, with males bearing a higher burden, indicating a relative reduction in disease burden. High SDI regions exhibit steeper declines in the burden of cancer attributable to smoking. Tracheal, bronchus, and lung, esophageal, and stomach cancers dominate, with ARIMA forecasts predicting continued reductions through 2041. It remains imperative to enhance tobacco control, especially in low SDI regions, to sustain this declining trend.</p>

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The disease burden of cancer attributable to smoking worldwide from 1990 to 2021: an analysis of the global burden of disease study 2021

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月27日

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  • Zhong-liu Wei,
  • Xin Zhou,
  • Xi-wen Liao,
  • Yong-guang Wei,
  • Hua-sheng Huang,
  • Chen-lu Lan,
  • Hai-xiang Xie,
  • Tao Peng

摘要

Objective

This study aims to analyze global trends in cancer deaths and disability-adjusted life years (DALYs) attributable to smoking from 1990 to 2021 using the Global Burden of Disease (GBD) database, and to predict trends over the next 20 years.

Methods

This study utilized the 2021 GBD database to extract annual mortality, DALYs, and age-standardized rates for cancer attributable to smoking across 204 countries from 1990 to 2021. Joinpoint regression assessed temporal trends, calculating average annual percentage change (AAPC). Autoregressive Integrated Moving Average (ARIMA) modeling forecasted future disease burden for 20 years.

Results

From 1990 to 2021, global cancer attributable to smoking deaths and DALYs increased, with deaths rising from 1,328.88 to 2,012.85 thousand and DALYs from 35,581.64 to 47,976.55 thousand, despite declining age-standardized mortality (ASMR) from 33.76 to 23.31 per 100,000 (AAPC: -1.19) and DALYs (ASDR) from 863.94 to 546.86 per 100,000 (AAPC: -1.47). Males exhibited a higher burden, with ASMR at 42.68 and ASDR at 978.15 per 100,000 in 2021, compared to females (7.01 and 161.30). High Socio-demographic Index (SDI) regions showed the steepest ASMR decline (AAPC: -1.80). Tracheal, bronchus, and lung, esophageal, and stomach cancers dominated the burden. In 2021, specific regions within Greenland, Eastern Europe, Central Asia, East Asia, and the Middle East demonstrated notably higher compared to other regions. The ARIMA model predicts that the ASMR and ASDR for cancer attributable to smoking in both males and females will continue to decline from 2022 to 2041.

Conclusion

This study reveals a rising global burden of cancer attributable to smoking deaths and DALYs. However, ASMR and ASDR have decreased, with males bearing a higher burden, indicating a relative reduction in disease burden. High SDI regions exhibit steeper declines in the burden of cancer attributable to smoking. Tracheal, bronchus, and lung, esophageal, and stomach cancers dominate, with ARIMA forecasts predicting continued reductions through 2041. It remains imperative to enhance tobacco control, especially in low SDI regions, to sustain this declining trend.