Mortality and health losses from cardiovascular diseases attributable to tobacco smoking among adults in Ethiopia, from 1990 to 2023

Background Non-communicable diseases are the result of a combination of genetic, physiological, environmental and behavioral factors. Evidence revealed that tobacco smoking is a leading cause of CVDs-related disability and premature mortality among others. Nevertheless, there is dearth of evidence on national and substantial health risks and distribution of health losses from CVDs associated with tobacco smoking in Ethiopia.

Methods Data on mortality, disability-adjusted life years, years lived with disability, and years of life lost from CVDS attributable to tobacco smoking were extracted from the global burden of diseases 2023 study for Ethiopia and regions and administrative cities from 1990 to 2023. Comparative Risk Assessment Framework was used to generate the estimates. Disability-adjusted life years were obtained by adding the estimates of years lived with disability and years of life lost. Spatiotemporal Gausian process regression technique was employed to smooth the estimates. Rates were estimated per 100,000 population.

Results An estimated 98332.1 (95% UI: 81623.8, 116279.3) CVDs-related mortalities occurred among adults aged 20 years and above in Ethiopia in 2023. The corresponding age-standardized death rate of CVDs attributable to tobacco smoking was estimated to be 221.1 deaths per 100,000 population (95% UI: 182.1, 261.5). A higher than the national age standardized death rate was estimated in Afar [266.2 (95% UI: 205.1, 332.2)], Benishangul-Gumuz [268.3 (95% UI: 216.9, 321.3)], South west [334.9 (95% UI: 250.3, 459.7)], and Addis Ababa [342.8 (95% UI: 260.6, 418.6)]. The age-standardized rate was estimated to be 5317.8 disability-adjusted life years (95% UI: 4503.3, 6237.6), 375.9 years lived with disability (95% UI: 275.9, 488.9), and 4941.9 years of life lost (95% UI: 4152.4, 5809.5). Stroke and ischemic heart disease were found to be the leading causes of deaths attributable to tobacco smoking. There was no significant trend shift in all the rates from 1990 to 2023.

Conclusion This study has revealed that tobacco smoking continued to inflict substantial burden of disability and mortality among adults aged 20 years and above in Ethiopia, with subnational variation and stable trend over the past three decades. Ischemic stroke, ischemic heart disease, and intracerebral hemorrhage were found to be the leading causes of disability and premature mortality.