Cancer mortality attributable to cigarettes smoking in Tunisian adults, 2016

Abstract

Abstract Background The carcinogenic effect of tobacco smoking has been well established. In Tunisia, cancers ranked second leading cause of deaths from non-communicable diseases in 2014. In addition, Tunisia is classified among North African countries with the highest prevalence of tobacco smoking. We aimed in this study to estimate cancer mortality attributable to current cigarettes smoking among Tunisian adults aged 30 years and older in 2016. Methods Cancer mortality attributable to current cigarettes smoking was estimated using the population attributable fraction method. This estimation requires to have the number of deaths by cause, age and gender, the prevalence of tobacco use by age and gender, and the relative risks (RR) as measure of associations of tobacco use and diseases related to tobacco. The age and cause specific number of deaths were obtained from the health metrics database. The relative risks were mainly obtained from the Cancer Prevention Study II and the prevalence of current cigarettes smoking in Tunisia was taken from the Tunisian Health Examination Survey, a nationally representative household survey conducted in 2016. Results In 2016, 2410 and 31 deaths among Tunisian men and women respectively were attributable to current cigarettes smoking accounting for 54.3% and 1.7% of all deaths from cancers. Among neoplasms, lung and upper aerodigestive tract cancers had the highest proportion of deaths attributable to tobacco smoking. They were responsible for 1702 and 392 deaths attributable to current cigarettes smoking corresponding to 74.5% and 49.1% of the total number of deaths from lung and upper aerodigestive tract cancers respectively. Conclusions More than half of cancer deaths among Tunisian men were attributable to current cigarettes smoking. The enforcement of smoking free legislation and the promotion of smoking cessation interventions are thus necessary. Key messages Majority of all cancer deaths observed among Tunisian men aged 30 years and over in 2016 were attributable to current cigarettes smoking. Lung cancer had the highest proportion of deaths attributable to Tobacco.