Smoking attributable mortality in the community of Madrid: 1992-1998

Background: The proportion of smokers and the number of cigarettesconsumed per person-year in Madrid is above the European average.To evaluate the impact of smoking in public health smoking attributablemortality was estimated for 1998 and for changes since 1992.Methods: The number of smoking attributable deaths and yearsof potential life lost attributable to cigarette smoking for1992 and 1998 by gender and age group were estimated, basedon the population attributable fraction. The relative risksof the Cancer Prevention Study II were used. To compare thetwo periods of study, a Poisson regression analysis adjustedby age was applied. Results: In 1998, 15.9% of total mortalityin the population older than 34 years was attributable to smoking.Lung cancer and chronic obstructive pulmonary disease are themain causes of death in both genders. In the period studied,1992–1998, the adjusted rates diminished in men in bothage groups, while in women they increased in the age group 35to 64 years. The mortality from lung cancer remained stablein men, increasing in women by 12%. The years of potential lifelost decreased by 14% in men and increased by 42% in women.Conclusions: One in four deaths in men and one in 36 deathsin women are attributed to cigarette smoking. The smoking attributablemortality in males has tended to stabilize, while in women prematuremortality is increasing. Key points

• Smoking attributable mortality was estimated for 1998 and forchanges since 1992 to evaluate the impact of smoking in thepopulation older than 34 years.

MAIN RESULTS

• In the period studied, 1992–1998, the adjusted mortalityrates attributable to smoking diminished in men, while in womenthey increased in the age group 35 to 64 years.
• The main causesof Smoking attributable mortality are Lung cancerand chronicobstructive pulmonary disease in both genders. Themortalityfrom lung cancer remained stable in men, increasingin womenby 12%.

IMPLICATIONS FOR PUBLIC HEALTH

• In the Community of Madrid, health promotion programmes to reducecigarette smoking need to be intensified, specially in women