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    "titulo" => "The burden of disease attributable to smoking in Portugal"
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        "titulo" => "Abstract"
        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The World Health Organization&#39;s &#40;WHO&#41; 2002 Annual Report estimated that about 14&#37; of the burden of disease in wealthier countries is attributable to smoking&#46; Smoking related diseases include cardiovascular diseases&#44; cancer and respiratory diseases&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This paper presents an estimate of the burden of disease attributable to smoking in Portugal&#46; The estimates are based on the Portuguese demographic and health statistics available for 2005&#46; The most important conclusion of the analysis is that 11&#46;7&#37; of deaths in Portugal are attributable to smoking&#46; If we use disability adjusted life years &#40;DALYs&#41; to measure the burden of disease&#44; we find that 11&#46;2&#37; of death DALYs in Portugal is attributable to smoking&#46; The gender distribution of this amount is very unequal&#59; 15&#46;4&#37; of the male burden of disease and 17&#46;7&#37; of all male deaths can be attributed to smoking&#44; but only 4&#46;9&#37; of the female burden of disease and 5&#46;2&#37; of all female deaths&#46; These estimates are higher than death estimates previously available &#40;Peto <span class="elsevierStyleItalic">et al</span>&#46; 2006&#41;&#59; 14&#37; in men and only 0&#46;9&#37; in women&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">This paper also presents estimates of the burden of reducible disease&#44; that is&#44; the reduction in mortality and DALYs that would occur if all current smokers quit and thus experienced the mean risk of ex-smo kers&#44; which is lower than for current smokers but typically not as low as for never-smokers&#46; Our estimates are that the burden of disease would decrease by 5&#46;8&#37; &#40;7&#46;8&#37; in men and 2&#46;8&#37; in women&#41;&#44; and that deaths would decrease by 5&#46;8&#37; as well &#40;with an 8&#46;5&#37; and 2&#46;9&#37; decrease in men and women&#44; respectively&#41;&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The paper also includes estimates of the burden of disease ge nerated by smoking related disability&#46; Smoking related illnesses generated 121&#44;643 DALYs&#44; 72&#44;126 &#40;59&#37;&#41; of which are attributable to smoking and 12&#44;417 would be reducible if all smokers were to quit&#46;</p>"
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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A Organiza&#231;&#227;o Mundial de Sa&#250;de &#40;OMS&#41; estimou no seu relat&#243;rio de 2002 que cerca de 14&#37; da carga da doen&#231;a nos pa&#237;ses mais ricos seja atribu&#237;vel ao consumo de produtos de tabaco&#46; As doen&#231;as mais relacionadas com o consumo de tabaco incluem um conjunto de doen&#231;as cardiovasculares&#44; neoplasias e doen&#231;as respirat&#243;rias&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Este artigo estima a carga da doen&#231;a atribu&#237;vel ao tabaco em Portugal&#44; tomando como base os dados das estat&#237;sticas demogr&#225;ficas e de sa&#250;de dispon&#237;veis para Portugal em 2005&#46; A conclus&#227;o final da an&#225;lise &#233; que 11&#44;7&#37; das mortes em Portugal se podem atribuir ao consumo de tabaco&#46; Se medirmos a carga da doen&#231;a atrav&#233;s dos anos de vida ajustados por incapacidade &#8211; <span class="elsevierStyleItalic">disability adjusted life years</span> &#40;DALY&#41; gerados pela mortalidade&#44; as propor&#231;&#227;o da carga da doen&#231;a atribu&#237;vel ao tabaco &#233; 11&#44;2&#37;&#46; A divis&#227;o entre sexos &#233; muito desigual&#44; j&#225; que 15&#44;4&#37; da carga da doen&#231;a masculina e 17&#44;7&#37; das mortes s&#227;o atribu&#237;veis ao tabaco&#44; mas apenas 4&#44;9&#37; da carga da doen&#231;a feminina e 5&#44;2&#37; das mortes&#46; Estes n&#250;meros para a mortalidade atribu&#237;vel s&#227;o mais elevados do que as estimativas anteriormente dispon&#237;veis para Portugal &#40;Peto <span class="elsevierStyleItalic">et al&#46;</span> 2006&#41;&#44; as quais apontavam para 14&#37; das mortes masculinas e apenas 0&#44;9&#37; das femininas&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">O artigo apresenta estimativas sobre a carga da doen&#231;a redut&#237;vel&#44; ou seja&#44; as redu&#231;&#245;es de mortalidade e DALY que ocorreriam se os fumadores abandonassem o tabagismo e passassem a experimentar o risco m&#233;dio das popula&#231;&#245;es de ex-fumadores&#44; o qual &#233; superior ao dos nunca fumadores mas inferior ao dos fumadores&#46; As estimativas s&#227;o que a carga da doen&#231;a medida pelos DALY se reduziria em 5&#44;8&#37; &#40;7&#44;8&#37; dos homens e 2&#44;8&#37; das mulheres&#41; e que as mortes se reduziriam em 5&#44;8&#37; &#40;8&#44;5&#37; homens e 2&#44;9&#37; mulheres&#41;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">O artigo inclui igualmente estimativas dos DALY perdidos por incapacidade&#46; As doen&#231;as relacionadas com o tabagismo geraram 121 643 DALY&#44; dos quais 72 126 &#40;59&#37;&#41; s&#227;o atribu&#237;veis ao tabagismo e 12 417 &#40;10&#37;&#41; s&#227;o redut&#237;veis&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Agradecemos o apoio dos Laborat&#243;rios Pfizer&#44; Lda&#46;&#44; e do INSA Ricardo Jorge pelo acesso aos dados do 4&#46;&#176; Inqu&#233;rito Nacional de Sa&#250;de&#46; Quaisquer erros ou omiss&#245;es s&#227;o da responsabilidade dos autores&#47;<span class="elsevierStyleItalic">We gratefully acknowledge the support of Pfizer Laboratories Lda and the INSA Ricardo Jorge for access to 4</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">th</span></span><span class="elsevierStyleItalic">National Health Enquiry data&#46; Any errors or omissions are the sole responsibility of the authors</span>&#46;</p>"
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Vol. 15. Issue 6.
Pages 951-1004 (November - December 2009)
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Vol. 15. Issue 6.
Pages 951-1004 (November - December 2009)
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The burden of disease attributable to smoking in Portugal
Carga da doença atribuível ao tabagismo em Portugal
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Margarida Borges, Miguel Gouveia, João Costa, Luís dos Santos Pinheiro, Sérgio Paulo, António Vaz Carneiro
Centro de Estudos de Medicina Baseada na Evidência, Faculdade de Medicina de Lisboa/Evidence-Based Medicine Centre for Studies, Lisbon University School of Medicine
Centro de Estudos Aplicados, Faculdade de Ciências Económicas e Empresariais, Universidade Católica Portuguesa/Universiade Católica Portuguesa Faculty of Economic and Business Science Centre for Applied Studies
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Abstract

The World Health Organization's (WHO) 2002 Annual Report estimated that about 14% of the burden of disease in wealthier countries is attributable to smoking. Smoking related diseases include cardiovascular diseases, cancer and respiratory diseases.

This paper presents an estimate of the burden of disease attributable to smoking in Portugal. The estimates are based on the Portuguese demographic and health statistics available for 2005. The most important conclusion of the analysis is that 11.7% of deaths in Portugal are attributable to smoking. If we use disability adjusted life years (DALYs) to measure the burden of disease, we find that 11.2% of death DALYs in Portugal is attributable to smoking. The gender distribution of this amount is very unequal; 15.4% of the male burden of disease and 17.7% of all male deaths can be attributed to smoking, but only 4.9% of the female burden of disease and 5.2% of all female deaths. These estimates are higher than death estimates previously available (Peto et al. 2006); 14% in men and only 0.9% in women.

This paper also presents estimates of the burden of reducible disease, that is, the reduction in mortality and DALYs that would occur if all current smokers quit and thus experienced the mean risk of ex-smo kers, which is lower than for current smokers but typically not as low as for never-smokers. Our estimates are that the burden of disease would decrease by 5.8% (7.8% in men and 2.8% in women), and that deaths would decrease by 5.8% as well (with an 8.5% and 2.9% decrease in men and women, respectively).

The paper also includes estimates of the burden of disease ge nerated by smoking related disability. Smoking related illnesses generated 121,643 DALYs, 72,126 (59%) of which are attributable to smoking and 12,417 would be reducible if all smokers were to quit.

Key-words:
Tobacco consumption
cardiovascular disease
coronary heart disease
cerebrovascular disease
disability adjusted life years
DALYs
burden of disease
Resumo

A Organização Mundial de Saúde (OMS) estimou no seu relatório de 2002 que cerca de 14% da carga da doença nos países mais ricos seja atribuível ao consumo de produtos de tabaco. As doenças mais relacionadas com o consumo de tabaco incluem um conjunto de doenças cardiovasculares, neoplasias e doenças respiratórias.

Este artigo estima a carga da doença atribuível ao tabaco em Portugal, tomando como base os dados das estatísticas demográficas e de saúde disponíveis para Portugal em 2005. A conclusão final da análise é que 11,7% das mortes em Portugal se podem atribuir ao consumo de tabaco. Se medirmos a carga da doença através dos anos de vida ajustados por incapacidade – disability adjusted life years (DALY) gerados pela mortalidade, as proporção da carga da doença atribuível ao tabaco é 11,2%. A divisão entre sexos é muito desigual, já que 15,4% da carga da doença masculina e 17,7% das mortes são atribuíveis ao tabaco, mas apenas 4,9% da carga da doença feminina e 5,2% das mortes. Estes números para a mortalidade atribuível são mais elevados do que as estimativas anteriormente disponíveis para Portugal (Peto et al. 2006), as quais apontavam para 14% das mortes masculinas e apenas 0,9% das femininas.

O artigo apresenta estimativas sobre a carga da doença redutível, ou seja, as reduções de mortalidade e DALY que ocorreriam se os fumadores abandonassem o tabagismo e passassem a experimentar o risco médio das populações de ex-fumadores, o qual é superior ao dos nunca fumadores mas inferior ao dos fumadores. As estimativas são que a carga da doença medida pelos DALY se reduziria em 5,8% (7,8% dos homens e 2,8% das mulheres) e que as mortes se reduziriam em 5,8% (8,5% homens e 2,9% mulheres).

O artigo inclui igualmente estimativas dos DALY perdidos por incapacidade. As doenças relacionadas com o tabagismo geraram 121 643 DALY, dos quais 72 126 (59%) são atribuíveis ao tabagismo e 12 417 (10%) são redutíveis.

Palavras-chave:
Tabagismo
doença cardiovascular
doença coronária
doença cerebrovascular
doenças respiratórias
anos de vida ajustados por incapacidade
DALY
carga da doença
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Agradecemos o apoio dos Laboratórios Pfizer, Lda., e do INSA Ricardo Jorge pelo acesso aos dados do 4.° Inquérito Nacional de Saúde. Quaisquer erros ou omissões são da responsabilidade dos autores/We gratefully acknowledge the support of Pfizer Laboratories Lda and the INSA Ricardo Jorge for access to 4thNational Health Enquiry data. Any errors or omissions are the sole responsibility of the authors.

Copyright © 2009. Sociedade Portuguesa de Pneumologia
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