Mortality attributable to smoking in Vietnamese men in 2008

• Published in: Preventive medicine 2013-09, Vol.57 (3), p.232-237
• Main Authors: Norman, Rosana E, Vos, Theo, Barendregt, Jan J, Linh, Bui Ngoc, Huong, Nguyen Thanh, Higashi, Hideki, Carnahan, Emily, Lopez, Alan D
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; Biological and medical sciences; Cessation; Health Policy; Humans; Internal Medicine; Lung Neoplasms - etiology; Lung Neoplasms - mortality; Male; Medical sciences; Men; Middle Aged; Miscellaneous; Mortality; Needs Assessment; Population attributable fraction; Prevalence; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Pulmonary Disease, Chronic Obstructive - etiology; Pulmonary Disease, Chronic Obstructive - mortality; Sex Factors; Smoking; Smoking - mortality; Smoking attributable mortality; Tobacco; Tobacco Use Cessation; Tobacco, tobacco smoking; Toxicology; Uncertainty; Vietnam; Vietnam - epidemiology
• ISSN: 0091-7435; 1096-0260
• DOI: 10.1016/j.ypmed.2013.05.016

Abstract Objective Smoking prevalence among Vietnamese men is among the highest in the world. Our aim was to provide estimates of tobacco attributable mortality to support tobacco control policies. Method We used the Peto–Lopez method using lung cancer mortality to derive a Smoking Impact Ratio (SIR) as a marker of cumulative exposure to smoking. SIRs were applied to relative risks from the Cancer Prevention Study, Phase II. Prevalence-based and hybrid methods, using the SIR for cancers and chronic obstructive pulmonary disease and smoking prevalence for all other outcomes, were used in sensitivity analyses. Results When lung cancer was used to measure cumulative smoking exposure, 28% (95% uncertainty interval 24–31%) of all adult male deaths (> 35 years) in Vietnam in 2008 were attributable to smoking. Lower estimates resulted from prevalence-based methods [24% (95% uncertainty interval 21–26%)] with the hybrid method yielding intermediate estimates [26% (95% uncertainty interval 23–28%)]. Conclusion Despite uncertainty in these estimates of attributable mortality, tobacco smoking is already a major risk factor for death in Vietnamese men. Given the high current prevalence of smoking, this has important implications not only for preventing the uptake of tobacco but also for immediate action to adopt and enforce stronger tobacco control measures.