Objective: To explore how much of the coronary heart disease (CHD) mortality
fall in England and Wales can be attributed to changes in smoking prevalence.
Methods: A previously validated cell-based IMPACT CHD mortality model was used to estimate
the deaths prevented or postponed by changes in population smoking prevalence in England
and Wales between 1981 and 2000. CHD mortality statistics and population trends in smoking
were obtained from routine data sources.
Results: In England and Wales between 1981
and 2000, smoking prevalence in adults aged 25-84 decreased from 43% to 28% in men and
from 35% to 24% in women. In men, most of the decrease occurred in those aged over 55.
Smoking prevalence changed little in older women. An estimated 29,460 deaths were prevented
or postponed (DPP) by this population reduction in smoking prevalence. Most of this
benefit was seen in men (86% of the DPPs versus 14% in women).
Conclusions: Large declines
in smoking prevalence accounted for 29,460 fewer CHD deaths in England and Wales
in 2000 compared with 1981. This emphasises the importance of a national strategy with
comprehensive tobacco control programmes to further reduce smoking.
REFERENCES(26)
1.
Kuulasmaa K, Tunstall PH, Dobson AJ, et al: Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project. Lancet. 2000, 355: 675-87. 10.1016/S0140-6736(99)11180-2.
Jackson R, Stewart A, Beaglehole R: Trends in coronary heart disease mortality and morbidity in Auckland, New Zealand, 1974–1986. Int J Epidemiol. 1990, 19: 279-83. 10.1093/ije/19.2.279.
Sigfusson N, Sigvaldson H, Steingrimsdottir L, et al: Decline in ischaemic heart disease in Iceland and change in risk factor levels. BMJ. 1991, 302: 1371-5. 10.1136/bmj.302.6789.1371.
McGovern PG, Pankow JS, Shahar E, et al: Recent trends in acute coronary heart disease mortality, morbidity, medical care, and risk factors. The Minnesota Heart Survey Investigators. N Engl J Med. 1996, 334: 884-90. 10.1056/NEJM199604043341403.
Isles CG, Hole DJ, Hawthorne VM, Lever AF: Relation between coronary risk and coronary mortality in women of the Renfrew and Paisley survey: comparison with men. Lancet. 1992, 339: 702-6. 10.1016/0140-6736(92)90599-X.
U.S. Department of Health and Human Services: Reducing the Health Consequences of Smoking: 25 Years of Progress. A Report of the Surgeon General. 1989, Rockville, Maryland: DHHS Publication No. (CDC), 89-8411.
Jousilahti P, Vartiainen E, Tuomilehto J, Puska P: Sex, age, cardiovascular risk factors, and coronary heart disease: a prospective follow-up study of 14 786 middle-aged men and women in Finland. Circulation. 1999, 99: 1165-72.
U.S. Department of Health and Human Services: The Surgeon General's 1990 Report on the Health Benefits of Smoking Cessation. 1990, Rockville, Maryland: DHHS Publication No. (CDC), 89-8411.
Buck D: GCPSRM, University of York Centre for Health Economics. Cost effectiveness of smoking cessation interventions. 1997, London: Health Education Authority.
Capewell S, Morrison CE, McMurray JJ: Contribution of modern cardiovascular treatment and risk factor changes to the decline in coronary heart disease mortality in Scotland between 1975 and 1994. Heart. 1999, 81: 380-6.
Capewell S, Beaglehole R, Seddon M, McMurray J: Explaining the decline in Coronary Heart Disease Mortality in Auckland, New Zealand between 1982 and 1993. Circulation. 2000, 102: 1511-6.
ONS-Office for National Statistics: Mortality Statistics cause. Review of the Registrar General on deaths by cause, sex and age, in England and Wales, 1999. 2000, London, Stationery Office.
Shaper AG, Pocock SJ, Walker M, et al: British Regional Heart Study: cardiovascular risk factors in middle-aged men in 24 towns. BMJ. 1981, 283: 179-86. 10.1136/bmj.283.6285.179.
ONS-Office for National Statistics Social Survey Division: Living in Britain:Results from the 2000/01 General Household Survey. 2001, London: The Stationery Office.
Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ. 2002, 324: 71-86. 10.1136/bmj.324.7329.71.
Ryan R, Majeed A: Prevalence of ischaemic heart disease and its management with statins and aspirin in general practice in England and Wales, 1994–98. Health Statistics Quarterly. 2001, 12: 34-9.
Capewell S, Livingston BM, MacIntyre K, et al: Trends in case-fatality in 117 718 patients admitted with acute myocardial infarction in Scotland. Eur Heart J. 2000, 21: 1833-40. 10.1053/euhj.2000.2318.
Continuing decrease in coronary heart disease mortality in Sweden Johanna Berg, Lena Björck, Georgios Lappas, Martin O’Flaherty, Simon Capewell, Annika Rosengren BMC Cardiovascular Disorders
The Preventable Risk Integrated ModEl and Its Use to Estimate the Health Impact of Public Health Policy Scenarios Peter Scarborough, Richard A. Harrington, Anja Mizdrak, Lijuan Marissa Zhou, Aiden Doherty Scientifica
Non-communicable diseases and injuries in Pakistan: strategic priorities Tazeen H Jafar, Benjamin A Haaland, Atif Rahman, Junaid A Razzak, Marcel Bilger, Mohsen Naghavi, Ali H Mokdad, Adnan A Hyder The Lancet
Adverse risk factor trends limit gains in coronary heart disease mortality in Barbados: 1990-2012 N. Sobers, N. Unwin, T. Samuels, S. Capewell, M. O’Flaherty, J. Critchley, Wisit Cheungpasitporn PLOS ONE
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