RT Journal Article
SR Electronic
T1 Provincial-level cancer burden attributable to active and second-hand smoking in China
JF Tobacco Control
JO Tob Control
FD BMJ Publishing Group Ltd
SP 669
OP 675
DO 10.1136/tobaccocontrol-2018-054583
VO 28
IS 6
A1 Changfa Xia
A1 Rongshou Zheng
A1 Hongmei Zeng
A1 Maigeng Zhou
A1 Lijun Wang
A1 Siwei Zhang
A1 Xiaonong Zou
A1 Kexin Sun
A1 Zhixun Yang
A1 He Li
A1 Mark Parascandola
A1 Farhad Islami
A1 Wanqing Chen
YR 2019
UL http://tobaccocontrol.bmj.com/content/28/6/669.abstract
AB Background Understanding disparities in the burden of cancer attributable to smoking is crucial to inform and improve tobacco control measures. In this report, we estimate the population attributable fraction (PAF) of cancers deaths attributable to smoking at the national and provincial levels in China.Methods Using cancer mortality data from 978 counties, smoking data from a nationwide survey and relative risks from a prospective study of 0.5 million adults in China, we calculated the absolute (non-standardised) and standardised numbers and proportions of cancer deaths among adults 30 years and older attributable to active and second-hand smoking in 2014 across all 31 provinces in Mainland China.Results The estimated number of cancer deaths attributable to smoking in China in 2014 was 342 854 among men and 40 313 among women, of which second-hand smoking accounted for 1.8% and 50.0%, respectively. Among men, the absolute PAF in China was 23.8%, ranging from 14.6% in Xinjiang to 26.8% in Tianjin; the overall standardised PAF was 22.2%, ranging from 15.7% in Xinjiang to 26.0% in Guizhou. Among women, the overall absolute and standardised PAFs were 4.8% and 4.0%, ranging from 1.8% and 1.6% in Jiangxi to 14.9% and 9.6% in Heilongjiang, respectively. Overall, provinces with the highest standardised PAFs among men were located in Southwest China and among women in the Northeast.Conclusions Comprehensive smoke-free policies in China should expand to all provinces, notably those with a higher burden of cancer attributable to smoking, instead of being mostly limited to Beijing and some other metropolitan areas.