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Comparison of Prevalence- and Smoking Impact Ratio-Based Methods of Estimating Smoking-Attributable Fractions of Deaths

Authors :
Kyoung Ae Kong
Source :
Journal of Epidemiology, Vol 26, Iss 3, Pp 145-154 (2016)
Publication Year :
2016
Publisher :
Japan Epidemiological Association, 2016.

Abstract

Background: Smoking is a major modifiable risk factor for premature mortality. Estimating the smoking-attributable burden is important for public health policy. Typically, prevalence- or smoking impact ratio (SIR)-based methods are used to derive estimates, but there is controversy over which method is more appropriate for country-specific estimates. We compared smoking-attributable fractions (SAFs) of deaths estimated by these two methods. Methods: To estimate SAFs in 2012, we used several different prevalence-based approaches using no lag and 10- and 20-year lags. For the SIR-based method, we obtained lung cancer mortality rates from the Korean Cancer Prevention Study (KCPS) and from the United States-based Cancer Prevention Study-II (CPS-II). The relative risks for the diseases associated with smoking were also obtained from these cohort studies. Results: For males, SAFs obtained using KCPS-derived SIRs were similar to those obtained using prevalence-based methods. For females, SAFs obtained using KCPS-derived SIRs were markedly greater than all prevalence-based SAFs. Differences in prevalence-based SAFs by time-lag period were minimal among males, but SAFs obtained using longer-lagged prevalence periods were significantly larger among females. SAFs obtained using CPS-II-based SIRs were lower than KCPS-based SAFs by >15 percentage points for most diseases, with the exceptions of lung cancer and chronic obstructive pulmonary disease. Conclusions: SAFs obtained using prevalence- and SIR-based methods were similar for males. However, neither prevalence-based nor SIR-based methods resulted in precise SAFs among females. The characteristics of the study population should be carefully considered when choosing a method to estimate SAF.

Details

Language :
English
ISSN :
09175040 and 13499092
Volume :
26
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Journal of Epidemiology
Publication Type :
Academic Journal
Accession number :
edsdoj.11efb701e0d54a739e1e14ed4f6cbfb6
Document Type :
article
Full Text :
https://doi.org/10.2188/jea.JE20150058