Recent manuscripts
Archive
Editorial Board
Aims and Scope
Open Access
Indexing
Contact us
Authorship & COI
Principles of Transparency Checklist
Publication Ethics
Crossmark
Data Policies
Supporting Diversity
Instructions to authors (PDF)
Manuscript Types
Manuscript Formatting
How to submit
Special Publications & Reprints
Preprints
RESEARCH PAPER
Impact of Smoking Reduction on Coronary Heart Disease Mortality Trends During 1981–2000 in England and Wales
1
Department of Public Health, University of Liverpool, United Kingdom
2
Department of Public Health, Dokuz Eylul University School of Medicine, Izmir, Turkey
Publication date: 2003-09-15
Corresponding author
B Unal
Department of Public Health, Whelan Building, Quadrangle, The University of Liverpool, Liverpool, L69 3GB, UK
Department of Public Health, Whelan Building, Quadrangle, The University of Liverpool, Liverpool, L69 3GB, UK
Tobacco Induced Diseases 2003;1(September):185
KEYWORDS
ischaemic heart diseasesmoking prevalencecoronaryheart disease mortalityrisk factor levelgeneral household survey
ABSTRACT
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.
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.
2.
Vartiainen E, Puska P, Pekkanen J, Tuomilehto J, Jousilahti P: Changes in risk factors explain changes in mortality from ischaemic heart disease in Finland. BMJ. 1994, 309: 23-7.
3.
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.
4.
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.
5.
Sackett DL: Evidence-based medicine and treatment choices. Lancet. 1997, 349: 570-3. 10.1016/S0140-6736(97)80122-5.
6.
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.
7.
British Heart Foundation Statistics Database: Coronary Heart Disease Statistics. 2002, 17-2-2003, [http://www.dphpc.ox.ac.uk/bhfh...].
8.
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.
9.
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.
10.
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.
11.
Bottcher M, Falk E: Pathology of the coronary arteries in smokers and non-smokers. J Cardiovasc Risk. 1999, 6: 299-302.
12.
Powell JT: Vascular damage from smoking: disease mechanisms at the arterial wall. Vasc Med. 1998, 3: 21-8.
13.
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.
14.
Buck D: GCPSRM, University of York Centre for Health Economics. Cost effectiveness of smoking cessation interventions. 1997, London: Health Education Authority.
16.
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.
17.
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.
18.
ONS-Office for National Statistics: Population:Age and sex, 1971 onwards. Health Statistics Quarterly. 2001, 11.
19.
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.
20.
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.
21.
ONS-Office for National Statistics-Social Survey Division: General Household Survey 1980. 1982, London: Stationery Office.
22.
Erens B, Primatesta P: Health Survey for England. Cardiovascular Disease '98. 1999, London: Stationery Office.
23.
ONS-Office for National Statistics Social Survey Division: Living in Britain:Results from the 2000/01 General Household Survey. 2001, London: The Stationery Office.
24.
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.
25.
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.
26.
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.
CITATIONS (5):
1.
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
Johanna Berg, Lena Björck, Georgios Lappas, Martin O’Flaherty, Simon Capewell, Annika Rosengren
BMC Cardiovascular Disorders
2.
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
Peter Scarborough, Richard A. Harrington, Anja Mizdrak, Lijuan Marissa Zhou, Aiden Doherty
Scientifica
3.
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
Tazeen H Jafar, Benjamin A Haaland, Atif Rahman, Junaid A Razzak, Marcel Bilger, Mohsen Naghavi, Ali H Mokdad, Adnan A Hyder
The Lancet
5.
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
N. Sobers, N. Unwin, T. Samuels, S. Capewell, M. O’Flaherty, J. Critchley, Wisit Cheungpasitporn
PLOS ONE
Share
RELATED ARTICLE
| eISSN: | 1617-9625 |
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
