The fraction of ischaemic heart disease and stroke attributable to smoking in the WHO Western Pacific and South-East Asian regions
Key result
Smoking accounts for up to 33% of fatal ischaemic heart disease and up to 27% of ischaemic stroke fatalities among males in the WHO Western Pacific and South-East Asian regions.
Why the study?
What is the population attributable fraction of fatal ischaemic heart disease and stroke due to smoking in the WHO Western Pacific and South East Asian regions?
Population
Approximately 600,000 adult subjects in the Asia Pacific Cohort Studies Collaboration across 33 countries in…
Comparison
Smoking vs Non-smoking
Design
Cohort
Authors
Discussion
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Member takes
Implication
Highlights preventable CVD mortality burden from smoking in these regions; supports targeted prevention research but should not yet change practice.
Key Points
- To quantify the proportion of fatal ischaemic heart disease and stroke attributable to smoking across 38 countries in the WHO Western Pacific and South-East Asian regions.
- Gathered sex-specific smoking prevalence estimates from existing national survey data across 33 countries.
- Extracted hazard ratios for fatal ischaemic heart disease (IHD) and stroke from approximately 600,000 adult participants in the Asia Pacific Cohort Studies Collaboration (APCSC).
- Calculated sex-specific population attributable fractions (PAFs) for fatal IHD, ischaemic stroke, and haemorrhagic stroke for each country.
- Adult smoking prevalence across 33 evaluated countries ranged from 28% to 82% in males and from 1% to 65% in females.
- The population attributable fraction for fatal IHD ranged from 13% to 33% in males and from <1% to 28% in females.
- Smoking accounted for 11% to 27% of ischaemic stroke deaths in males (<1% to 22% in females) and 4% to 12% of haemorrhagic stroke deaths in males (<1% to 9% in females).
Study Design
Type
Observational (n=600,000)
Multicenter
Yes
Structured PICO
What is the population attributable fraction of fatal ischaemic heart disease and stroke due to smoking in the WHO Western Pacific and South East Asian regions?
P
Population
Approximately 600,000 adult subjects from the Asia Pacific Cohort Studies Collaboration used to estimate the population attributable fraction of fatal IHD and stroke due to smoking across 33 countries.
E
Exposure
Smoking
C
Comparator
Non-smoking
O
Outcome
Population attributable fractions (PAF) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic)hard clinical
Up to 30% of fatal ischaemic heart disease and stroke in the Western Pacific and South-East Asian regions can be attributed to smoking, highlighting a massive preventable cardiovascular burden.
Limitations
- Likely an underestimate of the current burden of smoking on CVD, given that the smoking epidemic has developed further since many of the studies were conducted.
- Likely an underestimate of the current burden of smoking on CVD because the smoking epidemic has developed further since many of the studies were conducted.
Cite This Study
Martiniuk et al. (2006) conducted an observational in Cardiovascular diseases (fatal ischaemic heart disease and stroke) (n=600,000). Smoking vs. Non-smokers was evaluated on Population attributable fractions (PAF) for fatal ischaemic heart disease (IHD) and stroke (haemorrhagic and ischaemic). Smoking accounts for up to 33% of fatal ischaemic heart disease and up to 27% of ischaemic stroke fatalities among males in the WHO Western Pacific and South-East Asian regions.