Mortalidad atribuida a la exposición al humo ambiental de tabaco en las comunidades autónomas de España

Abstract

Introduction and objectivesExposure to secondhand smoke (SHS) causes cardiovascular disease, respiratory disease, and cancer. The aim of this study was to estimate the mortality attributed to SHS in people aged ≥ 35 years in Spain and its autonomous communities (AC) by sex from 2016 to 2021. MethodsEstimates of SHS-attributable mortality were calculated by applying the prevalence-dependent method where SHS exposure was derived from the adjustment of small-area models and based on the calculation of population-attributed fractions. Age group, sex, AC, and cause of death (lung cancer and ischemic heart disease) were included. The estimates of attributed mortality are presented with 95%CI. Crude and age-standardized rates were estimated for each sex and AC. ResultsFrom 2016 to 2021, SHS exposure caused 4970 (95%CI, 4787-5387) deaths, representing 1.6% of total mortality for lung cancer and ischemic heart disease. The burden of attributed mortality differed widely among the AC, with Andalusia having the highest burden of attributed mortality (crude rate: 46.6 deaths per 100 000 population in men and 17.0 in women). In all the AC, the main cause of death in both sexes was stroke. The highest burden of mortality was observed in nonsmokers. ConclusionsThe burden of SHS-attributable mortality was high and varied geographically. The results of this study should be considered to advance tobacco control legislation in Spain.