Risk assessment of active smoking: smoking-attributable mortality and years of potential life lost in Taiwan, 1980 and 1992.
Anti-smoking programs have been advocated by the government and other private organizations for decades in Taiwan, especially in the past ten years. We conducted an analysis to assess the effectiveness of anti-smoking programs by examining the changes in active smoking attributable mortality (ASAM) and active smoking attributable years of potential life lost (ASAYPLL) between 1980 and 1992. This analysis also evaluated the present health impact due to active smoking. Total estimated ASAM was 12,765 for 1980 and 14,764 for 1992, representing 34.9% and 31.8% of all deaths from smoking-related causes for each year, respectively. Our results suggested a progress of anti-smoking efforts contributed by the government and other private anti-smoking organizations. By comparing the figures between 1980 and 1992, a reduction in all dimensions has been observed. The overall smoking prevalence rate decreased from 31.7% to 29.5% and the ASAM rate declined from 121.8/10(5) to 91.5/10(5). Additionally, the ASAYPLL rate declined from 513.4/10(5) to 406.9/10(5). Furthermore, the ratio of ASAM from cardiovascular diseases (CVD) to all ASAM decreased from 56.3% in 1980 to 46.7% in 1992, while the ratio of ASAM from cancer to all ASAM increased from 22.9% in 1980 to 34.9% in 1992. Our analysis also found that active smoking seemed to be a more important risk factor for smoking-related causes of death in people aged 41-65 than in people of other age group. Although the anti-smoking programs seemed effective over the past 13 years, active smoking still contributed to an estimated number of 14,764 deaths and 63,743 economically productive years lost in 1992. More efforts should be devoted to further reduce the high smoking prevalence in men and particularly to hamper the increasing smoking trend in adolescents and young women. This remains a challenge for the government of Taiwan.
Department of Epidemiology and Biostatistics, McGill University, Canada.
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D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D017281:Cost of Illness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D015995:Prevalence; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D000074606:Smoking Prevention; D013624:Taiwan / Q000453:epidemiology; D026712:Value of Life