Prevalence Of Tobacco Smoking Research Articles

Burden and Trends of Cancer in Bangladesh: Insights into Breast, Lung, Cervical, and Liver Cancers and Implications for Public Health Interventions

Burden and Trends of Cancer in Bangladesh: Insights into Breast, Lung, Cervical, and Liver Cancers and Implications for Public Health Interventions

Uptodate on lower extremity arterial disease- A review

Atherosclerotic cardiovascular disease (ASCVD) is defined as coronary heart disease (CHD), cerebrovascular disease, or Lower Extremity Arterial Disease (LEAD) also named peripheral arterial disease (PAD). ASCVD is considered to be of atherosclerotic origin and is the leading cause of morbidity and mortality mainly for individuals with diabetes mellitus (DM). Although the prognosis of LEAD is relatively benign regarding viability and survival of the affected limb, all patients with LEAD are at increased risk of myocardial infarction, ischemic stroke and cardiovascular death. Several studies indicated a two- to three-fold greater mortality in patients with LEAD than in age-matched controls with normal ankle-brachial index (ABI), with a five-year mortality of about 30% in patients with LEAD. LEAD is rapidly progressing worldwide due to demographic expansion, aging, increasing prevalence of tobacco smoking, sedentarity, hypertension, dyslipidemia, and type 2 diabetes. Among PWT2D the occurrence of LEAD is associated with a high risk of morbidity compared with people without diabetes. Pharmacological management in LEAD patients should include: lipid-lowering treatment, anticoagulant and anti-platelet treatment, vascular pleiotropic treatment and antihypertensive treatment. The non-pharmacological management of LEAD patient is the foundation of the therapeutic process and translates into reduced cardiovascular (CV) risk, improved prognosis, and better patients functioning. Modification of the risk factors profile may contribute to the reduction of the severity and progression of atherosclerosis as well as to a delay in the onset of complications. Study results show that the management of LEAD patients, both non-pharmacological and pharmacological is less intensive than the management of patients with coronary artery disease or cerebrovascular disease.

DYNAMICS OF TOBACCO SMOKING PREVALENCE AMONG STUDENTS AND DIRECTIONS OF ITS PREVENTION.

The aim: To study the dynamics of tobacco smoking prevalence among students and to find out the main directions of its prevention. Materials and methods: The research involved 647 students (men and women) of the first - fourth instructional years of pedagogical specialties. The research was conducted during 2020-2022. The research methods included analysis and generalization of literary source on the research topic, documentary method, questionnaires, pedagogical observation and statistical methods. Results: It was found that the phenomenon of tobacco smoking has long historical roots and is widespread in all countries of the world. It was found that 32.4 % of male students and 14.9 % of female ones smoke; herewith, 16.0 % of male and 8.3 % of female students smoke up to 10 cigarettes per day. It is established that a number of normative legal documents have been adopted and a system of preventive measures has been developed in order to counteract smoking among students. Conclusions: Smoking is a significant health and social problem the solution of which requires significant human and financial resources. Despite some achievements in this area, the active involvement of not only men, but also women, mainly students, in smoking is of particular concern. The use of tobacco products provokes a threat to the health of students and the population as a whole, which requires additional efforts on the part of society, government agencies and non-governmental organizations to prevent this addiction.

The Effects of A Community-based Health Program on Adolescents’ Smoking Prevention – A Quasi-Experimental Study

Background: Tobacco Smoking is considerably high among adolescents in Indonesia, indicating the potential proportion of tobacco smoking effects experienced by young Indonesians in the future and the need of program interventions to halt the tendency. This study aims to investigate effects of a community-based health promotion intervention on smoking prevention among Indonesians’ adolescents.Methods: The quasi-experimental study with a pre-and-posttest control group design involved 104 adolescents aged between 12 to 14 years. The adolescents were convieniently assigned into one intervention (55 adolescents) or a control group group (49 adolescents), with participants in the intervention group received four health promotion sessions using smoking prevention videos for one month. Effects of the intervention were measured by a questionnaire at one week before and after the intervention completed and then analyzed by an approprite data analysis technique.Results: After the intervention completion, there was a significant positive effect of the community-based health promotion intervenstion program in improving adolescents tobacco smoking knowledge, attitude, intention and behavior (p = <0.001).Conclusion: Community-based health promotion program provides positive impact on adolescents smoking prevention and therefore should be considered as one of stretegies for tobacco smoking prevention program.

Association between carotid intima media thickness and acute ischemic stroke at an Indonesian tertiary referral hospital

ObjectivesA high prevalence of tobacco smoking contributes to a high incidence of acute ischemic stroke (AIS) in Indonesia. Large-artery atherosclerosis is known to be a significant cause of AIS. The present study was aimed at evaluating the association between AIS and atherosclerosis on the basis of carotid intima-media thickness (CIMT) measurements in a tertiary care hospital in Indonesia. MethodsA total of 79 patients with AIS (case study group) and 79 individuals without AIS (control group) were included. Chi-squared tests and odds ratios were used to compare the groups and determine associations. We also considered factors such as age, body mass index (BMI), sex, type-2 diabetes mellitus (T2DM), hypertension, smoking status, dyslipidemia, socioeconomic status, and educational level in the statistical analyses. A p-value <0.05 was considered statistically significant. ResultsStratification of atherosclerosis into case study and control groups with respect to all study variables indicated a significant relationship (p > 0.05) between atherosclerosis and all variables except low socioeconomic status (p = 0.265) and low educational level (p = 0.180). Regression analysis demonstrated that a BMI ≥25 kg/m2, compared with a normal BMI, was associated with a 2.139-fold higher risk of atherosclerosis. ConclusionsAIS was associated with atherosclerosis, on the basis of CIMT measurements, according to age, BMI, sex, T2DM, hypertension, smoking status, dyslipidemia, socioeconomic status, and education level in the Indonesian population.

Impact of waterpipe tobacco taxation on consumption, government revenue and premature deaths averted in Jordan, Lebanon and Palestine: a simulation study

IntroductionDespite the high prevalence of waterpipe tobacco smoking in the Eastern Mediterranean region, evidence supporting its fiscal measures is limited. We modelled the impact of waterpipe tobacco-specific excise taxes on...

Clinical Feature, Lifestyle Behavior and Non-Communicable Diseases Comorbidities Among Psoriasis Patients in Shanghai: Gender Disparity Analysis Based on a Cross-Sectional Study.

Gender difference is prevalent in clinical feature, disease severity for noncommunicable diseases (NCD), but studies on gender disparity in clinical feature, disease severity and NCD comorbidity among psoriasis patients are limited. This cross-sectional study explores gender differences in clinical feature, lifestyle behavior and NCD comorbidity among psoriasis patients. Psoriasis patients were recruited through cluster survey method in two hospitals, and questionnaire interviews were applied to collect the demographic feature, lifestyle habits, clinical feature and NCD among patients. A total of 2102 psoriasis patients included 1332 males (63.4%), 70% were over 35 years old and approximately 50% of them were overweight or obesity. The median value for psoriasis initiation age and disease duration was 33 years old (34 for male and 32 for female) and 9 years (10 for male and 7 for female), respectively. The psoriasis recurrence was mainly in winter (73.4%) and autumn (34.2%) both for patients. The prevalence of tobacco smoking and alcohol drinking was 31.2% and 12.6%. Male patients had higher prevalence of tobacco smoking (odds ratio (OR) = 13.26, 95% confidence interval (CI): 9.54-18.44) and alcohol drinking (OR = 14.44, 95% CI: 7.90-26.40). The prevalence of diabetes, hypertension, hyperlipidemia, and metabolic syndrome were 13.2%, 28.5%, 23.4% and 21.5%, respectively. Male patients had higher prevalence of diabetes (OR = 1.53, 95% CI: 1.16-2.02), hypertension (OR = 1.87, 95% CI: 1.52-2.30), hyperlipidemia (OR = 2.34, 95% CI: 1.85-2.95) and metabolic syndrome (OR = 2.06, 95% CI: 1.63-2.62) than female patients. The proportions for 4 types of NCDs diagnosed after psoriasis onset were over 58%, which were also higher in males than females. Female patients had shorter disease duration and with less NCD, and male patients had more body weight issue, with fewer sleep time and higher prevalence of tobacco smoking and alcohol drinking and NCDs. We recommend that dermatologist should notice the gender disparity in psoriasis patients, which is helpful for the disease diagnosis and treatment.

An Exploration of Smoking Patterns Among People with Serious Mental Illness Attending an Outpatient Clinic in Qatar.

Studies have shown that tobacco use is exceptionally high in people affected with serious mental illness (SMI). Many countries worldwide have observed a decrease in the prevalence of tobacco smoking; however, the smoking rates among people with SMI have declined much less than in those without mental illness. To date, no nationally representative data have examined the smoking patterns or the sociocultural factors that influence smoking among SMI people in Qatar. A retrospective medical chart review was conducted to collect patient demographics, psychiatric and medical comorbidities, medications, the most recently documented smoking status and if on tobacco cessation treatment. A descriptive and inferential analysis of the data was performed. Of 346 patients included in the cohort, 196 (56.6%) had their smoking status documented, of which 72 (36.7%) were "currently smoking." Significantly more males than females were "current smokers" (62.9% versus 15.0%, respectively, p < 0.001). Significantly more patients with psychotic disorders than those with any other SMI were "current smokers", and this difference was statistically significant (p = 0.006). Positive and significant associations with current smoking were found for the male gender, psychotic disorders, and high levels (≥6.2 mmol/L) of total cholesterol. Only 12 (16.7%) of current smokers were receiving smoking cessation treatment. More than half of a sample of people with SMI attending outpatient psychiatric services in Qatar had documented smoking status. Still, only a few current smokers were on smoking cessation treatment. Efforts are needed to implement smoking cessation strategies in this population.

Prevalence and determinants of second-hand tobacco smoking in Pakistan.

Exposure to second-hand tobacco smoke is a public health problem in countries with high prevalence of active smoking such as Pakistan. However, few studies have assessed the prevalence and risk factors for exposure to second-hand tobacco smoke. To estimate the prevalence and factors associated with exposure to second-hand tobacco smoke in Pakistan. This study used data from the 2017-2018 Pakistan Demographic and Health Survey to calculate the prevalence and determinants of second-hand tobacco smoke exposure. Sociodemographic characteristics, family size and exposure to media by the respondents were the independent variables. The chi-square test and logistic regression analyses were used to evaluate the relationship between exposure to second-hand tobacco smoke and the independent variables.hy9. The survey included 61 940 adults, of which 30 027 (48.5%) were males and 31 913 (51.5%) females. The overall prevalence of exposure to second-hand tobacco smoke was 34.3%: 35.6% among males and 33.2% among females. Higher education level and rural residence were significantly positively associated with exposure to second-hand tobacco smoke among both sexes. Having a radio was inversely associated with exposure while having a television was positively associated with exposure among both sexes. Large family size was inversely associated with exposure. Currently and previously married females had significantly greater risk of exposure than never-married females. Tailored health interventions and policies are needed that target populations at high-risk of exposure to second-hand tobacco smoke. Strict smoking bans in public places should be implemented to limit exposure to second-hand tobacco smoke in Pakistan.

Evaluation of Nationwide Oral Mucosal Screening Program for Oral Cancer Mortality among Men in Taiwan.

The nationwide oral cancer screening program was launched for high-risk people (tobacco smokers or betel-nut chewers) in 1999 in Taiwan, but no study has taken the prevalence of tobacco smoking and betel-nut chewing into account for evaluating the impact of the screening program on oral cancer mortality. This study incorporated the risk fraction method with interrupted time-series analysis to evaluate the impact of the nationwide oral mucosal screening program among men in Taiwan. This study estimated the expected oral cancer mortality trend if the screening program had not launched in 1999, which revealed that the increasing oral cancer mortality trend would level off after 2009 due to the declining prevalence of tobacco smoking and betel-nut chewing. In 2000-2007, the percentage changes between the observed (implementation of the screening program) and expected (if the screening program had not launched) oral cancer mortality rate was not statistically significant for each age group. In 2008-2020, the significant percentage changes were -178% (99% CIs: -140.8 to -215.2), -75.4% (-59.4 to -91.4), -33.7% (-24.7 to -42.7), -18.8% (-12.0 to -25.6), and -15.3% (-9.5 to -21.2) for age groups of 30-34, 35-39, 40-44, 45-49, and 50-54, respectively. In addition to its influence on tobacco smoking and betel-nut chewing, the oral mucosal screening program was associated with the reduction of oral cancer mortality among men in Taiwan.

Prevalence of tobacco smoking and cannabis use in young men in South Africa.

Prevalence of tobacco smoking and cannabis use in young men in South Africa.

Prevalence of tobacco consumption and the associated factors among the adults in an urban slum: Findings from the WHO STEPwise survey.

Despite Pakistan's stringent tobacco control policy, its effective implementation has always been a challenge, leading to rising tobacco consumption. The aim of the study is to determine the prevalence of tobacco consumption and associated risk factors in the adult population of deprived urban areas. A community-based, cross-sectional survey was conducted from February to July 2019, comprising 607 adults residing in the urban squatter settlement of Lahore using a standardized questionnaire, the WHO STEPwise approach. The outcome was current use of tobacco and/or smokeless tobacco daily. Multivariable logistic regression was applied to determine factors associated with smoking and smokeless tobacco consumption. Among 607 participants, about 64% were females, 49.3% were illiterate, 64.9% were currently unemployed, and 47.1% belonged to the low-income group. The prevalence of tobacco smoke was 10.5% (95% CI: 8.07-12.93), and smokeless tobacco consumption was 8.6% (95% CI: 6.38-10.82). Multivariable logistic regression found that smokeless tobacco was more likely among the aged 50-59 years (AOR=4.1; 95% CI: 1.1-13.8) and unemployed (AOR=3.6; 95% CI: 1.1-12.2). Whereas tobacco smoking was more likely among the aged 30-39 years (AOR=5.5; 95% CI: 1.8-16.7), Urdu ethnicity (AOR=2.9; 95% CI: 1.2-7.3), unemployed (AOR=6.6; 95% CI: 2.9-14.9), and never exposed to any media (AOR=3.2; 95% CI: 1.8-17.4). Participants exposed to health warnings were less likely to smoke (AOR=0.02; 95% CI: 0.01-0.05). This study reports a high prevalence of tobacco consumption among adults and calls for effective policy implementation using a multi-pronged approach, including health professionals and media, to spread awareness about the harmful effects of tobacco and endorsement of health warnings on tobacco packaging.

Prevalence And Predictors of Exposure to Second-Hand Smoke Among Never-Tobacco Smokers

Background: Exposure to Second-hand tobacco smoke (SHS) harms health. It is a risk factor for various diseases like asthma, hypertension, diabetes, heart disease and lung cancer. This study aimed to determine the prevalence and predictors of second-hand tobacco smoke among adult never-smokers. Methods: A cross-sectional study was conducted among 220 participants aged 18 years and above. A pre-tested questionnaire was used to elicit information regarding exposure to second-hand smoke at the home, workplace and various public places. The data was analysed using the Epi Info software for windows. Results: The second-hand smoke exposure at home and workplace was 11.4% and 19.1%, respectively. The SHS exposure at bus stops, public transport, government buildings and health care facilities were 33.3%, 13.0%, 7.6% and 3%, respectively. The in-home study participants with a current tobacco smoker, family member and/or friend had comparatively higher exposure to second-hand tobacco smoke. In the workplace and or public places, male study participants and illiterate individuals had higher exposure to second-hand tobacco smoke. Conclusion: The observed level of SHS exposure among non-smokers is a public health concern. Family members should not allow anyone to smoke in their home environment. The public health law prohibiting tobacco smoking in workplaces and public places needs further strengthening.

Alarming trends in Tobacco use in high school Tunisian adolescents: MedSPAD2013-2021

Abstract Background Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged 13 to 15 years. No data related to high school students are however published yet. We aimed to determine tobacco smoking prevalence in Tunisian adolescents and assess trends from 2013 to 2021. Methods Pooled data from three Mediterranean school surveyson alcohol and other drugs (MedSPAD surveys: 2013, 2017, and 2021) were used. Based on three-stage stratification sampling method, teenagers aged between 15 and 17 years, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire assessing socio-demographic characteristics and risky behaviours. We studied weighted prevalence estimates of cigarettes and water pipe (WP) smoking. All statistical analysis, including trend analysis, were performed with STATA software. Results A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.6 and mean age of 16.2±0.8 years. The prevalence of cigarette smoking increased from 17.8%, to 20.2% then to 24.7% for 2013, 2017 and 2021, respectively. As for WP smoking, its prevalence increased from 14.8%, to 16.7% then to 19.9% for 2013, 2017 and 2021, respectively. Trends analysis concluded to significant increase over study period for cigarettes and WP smoking (p &amp;lt; 10-3). The increase was most alarming for girls regarding WP smoking (consistent increase over the study period). Conclusions Our findings underscore the alarming increasing trend for different forms of tobacco smoking among Tunisian youth. It is therefore crucial to strengthen tobacco control measures among young adolescents in order to counteract the tobacco industry’s expanding marketing of new products primarily targeting this population. Key messages • The prevalence of cigarette and water pipe smoking increased significantly among high school Tunisian adolescents from 2013 to 2021. • A better commitment to the implementation of MPOWER measures for tobacco control is therefore urgent.

Resumen PAPPS Infancia y Adolescencia 2022

Two important topics about children and adolescents in our primary care activity are presented in this update document: tobacco smoking prevention in adolescence and prophylaxis with vitamin K to prevent the hemorrhagic disease of the newborn.

Identification of smoking cessation phenotypes as a basis for individualized counseling: An explorative real-world cohort study.

INTRODUCTIONThe rate of relapse in smokers attempting to quit is generally high. In order to maximize the chances of success, it is of interest to better understand the dynamic of lapse and relapse during smoking cessation. We hypothesized that specific behavioral patterns in tobacco consumption could predict the probability of quitting success and could open the possibility for a more targeted approach. The aim of the current study was to characterize clusters of quitting trajectories among participants involved in a smoking cessation program.METHODSIn a retrospective real-world cohort study, data from 843 consecutive participants between March 2012 and December 2014 were collected. Data consisted of baseline information on demographics, smoking history and dependence level, as well as longitudinal data about tobacco consumption. The correlations among time series were characterized using principal coordinates analysis. Clusters were identified using k-means clustering and the average profile associated with each cluster was computed. The association between the participant’s baseline characteristics and clusters of tobacco consumption was assessed.RESULTSFour distinct clusters of transition phenotypes were identified based on tobacco consumption during the cessation phase: the long-term quitters (30%), the persistent smokers/reducers (44%), the short-term returners (16%) and the repeated try and failers (10%). Significant between-cluster differences were found in terms of baseline characteristics and smoking behavior during follow-up.CONCLUSIONSMeaningful clusters of quitting trajectories could be identified. Such specific behavioral patterns were useful for the application of personalized assistance needed to achieve successful and long-term cessation.

Specific aspects of tobacco smoking among Russian teenage girls

Purpose. The study is to analyze tobacco smoking among girls aged 15–17 years according to the data of the all-Russian epidemiological monitoring conducted in 2019–2020 and to identify the main aspects and directions of tobacco smoking prevention among girls.Materials and methods. In 2019–2020, on the basis of a multi-stage selection from 12 constituent entities of the Russian Federation (6 Federal Districts), secondary schools were selected by random sampling from urban areas, in which a continuous anonymous survey of students in grades 9–11 was conducted. The total number of respondents was 14084 teenagers (6535 boys and 7549 girls).Results. The data analysis showed that the prevalence of tobacco smoking among girls did not differ significantly from that of boys. Girls started smoking later than boys, but the intensity of initiation at the age of 13–14 years is higher than among boys. The structure of the motives of the first smoking test in boys and girls is the same. However, girls who tried smoking for the first time significantly outperformed boys by the motive «out of curiosity», and boys — «to feel like an adult» and «to please someone.» For most of the main reasons for smoking, girls did not differ significantly from boys, but girls smoked more often to «calm down,» and boys — «to seem more mature.» Awareness of the dangers of smoking among girls is slightly higher than among boys, and their sources of information are more reliable and scientifically based.Conclusion. In 2019–2020 the prevalence of tobacco smoking among girls for the first time in 20 years of monitoring has become the same as among boys, and in some surveyed cities — even higher. In our opinion, this is due to the fact that society’s attitude towards women smoking has changed. Tobacco smoking among women has become less condemned and quite acceptable. However, this working hypothesis requires further, more detailed study.

Changes in prevalence and predictors of tobacco smoking and interest in smoking cessation in Turkey: Evidence from the Global Adult Tobacco Survey, 2008-2016.

INTRODUCTIONTurkey conducted three rounds of the Global Adult Tobacco Survey (GATS) in 2008, 2012, and 2016 to monitor tobacco use and key tobacco control indicators. The prevalence estimate of adult tobacco use was 31.2% in 2008 and it declined to 27.1% in 2012.METHODSGATS is a nationally-representative, cross-sectional household survey of tobacco-use and related behaviors among adults aged ≥15 years. Outcome measures were prevalence of current tobacco smoking and interest in quitting smoking. Multivariable logistic regression analyses assessed changes in the adjusted prevalence and predictors of the outcome variables.RESULTSThe unadjusted prevalence of tobacco smoking among adults was 31.6% in 2016; a significant increase in the adjusted prevalence of 4.5% from 2012 to 2016. A significant 19.4% decline was observed in interest in quitting smoking from 2012 to 2016. Tobacco smoking was lower among women (adjusted prevalence ratio, APR=0.38) and rural residents (APR=0.79), and higher among adults aged 25–64 years compared to those aged 15–24 years (APR=1.63), and those who lived with other adults who smoke tobacco (APR=1.55). Predictors of increased interest in quitting smoking included rural residence (APR=1.13), higher education level (APR=1.21–1.36), awareness of anti-tobacco warnings and advertisements (APR=1.30), and belief that smoking causes severe health consequences (APR=1.57).CONCLUSIONSThis study identified opportunities to reduce tobacco smoking and increase interest in quitting, including increasing awareness of the health consequences of smoking and of evidence-based cessation resources. This study highlights Turkey’s commitment to assessing or monitoring tobacco use and key tobacco indicators to inform their policies and programs in a changing tobacco landscape.

Prevalence of smoking and smokeless tobacco use during breastfeeding: A cross-sectional secondary data analysis based on 0.32 million sample women in 78 low-income and middle-income countries.

SummaryBackgroundSmoking and smokeless tobacco use during the postpartum period is well studied in high-income countries, whereas low-income and middle-income countries (LMICs) lack evidence.MethodsIn this cross-sectional study we used data from the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted in 78 LMICs between January 2010 and December 2019 to study tobacco use among 0.32 million sample lactating women. Age-standardized prevalence of smoking and smokeless tobacco use was estimated and presented with a 95% Confidence Interval (CI) for 78 LMICs. Pooled estimates overall and by WHO regions were obtained using random-effects meta-analyses. Country-level and community-level variance to understand contextual factors was also quantified using multilevel modelling.FindingsPooled prevalence of any tobacco use among breastfeeding women in LMICs was 3.61% (95% CI 3.53–3.70); with the lowest prevalence in regions of the Americas (1.44%, 1.26–1.63) and the highest in the Southeast Asia region (6.13%, 6.0–6.27). The pooled prevalence of tobacco smoking was reported to be 1.16% (1.11–1.21), with the highest prevalence in the Eastern Mediterranean region (4.27%, 3.88–4.67) and the lowest in the African region (0.81%, 0.76–0.86). The pooled prevalence of smokeless tobacco use was reported to be 2.56% (2.49–2.63), with the highest prevalence in the Southeast Asia region (4.92%, 4.80–5.04). Illiterate and poor women in LMICs bore the enormous burden of tobacco use.InterpretationThe prevalence of smoking and smokeless tobacco use among lactating women in LMICs varied considerably across different WHO regions. Considering the cross-sectional design of the study, caution is required while interpreting the results. To improve mothers' and children's health and nutrition outcomes and reduce health inequalities in LMICs, reducing tobacco use through evidence-based interventions is critical.FundingNone.

Variation in smoking attributable all-cause mortality across municipalities in Belgium, 2018: application of a Bayesian approach for small area estimations

BackgroundSmoking is one of the leading causes of preventable mortality and morbidity worldwide, with the European Region having the highest prevalence of tobacco smoking among adults compared to other WHO regions. The Belgian Health Interview Survey (BHIS) provides a reliable source of national and regional estimates of smoking prevalence; however, currently there are no estimates at a smaller geographical resolution such as the municipality scale in Belgium. This hinders the estimation of the spatial distribution of smoking attributable mortality at small geographical scale (i.e., number of deaths that can be attributed to tobacco). The objective of this study was to obtain estimates of smoking prevalence in each Belgian municipality using BHIS and calculate smoking attributable mortality at municipality level.MethodsData of participants aged 15 + on smoking behavior, age, gender, educational level and municipality of residence were obtained from the BHIS 2018. A Bayesian hierarchical Besag-York-Mollie (BYM) model was used to model the logit transformation of the design-based Horvitz-Thompson direct prevalence estimates. Municipality-level variables obtained from Statbel, the Belgian statistical office, were used as auxiliary variables in the model. Model parameters were estimated using Integrated Nested Laplace Approximation (INLA). Deviance Information Criterion (DIC) and Conditional Predictive Ordinate (CPO) were computed to assess model fit.Population attributable fractions (PAF) were computed using the estimated prevalence of smoking in each of the 589 Belgian municipalities and relative risks obtained from published meta-analyses. Smoking attributable mortality was calculated by multiplying PAF with age-gender standardized and stratified number of deaths in each municipality.ResultsBHIS 2018 data included 7,829 respondents from 154 municipalities. Smoothed estimates for current smoking ranged between 11% [Credible Interval 3;23] and 27% [21;34] per municipality, and for former smoking between 4% [0;14] and 34% [21;47]. Estimates of smoking attributable mortality constituted between 10% [7;15] and 47% [34;59] of total number of deaths per municipality.ConclusionsWithin-country variation in smoking and smoking attributable mortality was observed. Computed estimates should inform local public health prevention campaigns as well as contribute to explaining the regional differences in mortality.