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SETTING: Smoking plays a major role in a variety of diseases. Despite a strong relationship between smoking and chronic obstructive pulmonary disease (COPD), cardiovascular disease and lung cancer attract greater attention. OBJECTIVE: To assess the burden of illness produced by smoking. DESIGN: Smoking-attributable risk (SAR) and smoking-attributable disease burden (mortality, morbidity, and cost) were estimated for four conditions: COPD, coronary heart disease (CHD), lung cancer, and stroke. RESULTS: Smoking-attributable deaths worldwide were: 1772580 COPD, 1 277000 CHD, 822150 lung cancer, and 788580 stroke. Smoking-attributable disability adjusted life years (DALYs) were: 47232000 COPD, 18106000 CHD, and 11052000 stroke. US smoking-attributable costs were: $26.0 billion CHD, $24.9 billion COPD, and $9.0 billion stroke. US smoking-attributable annual hospitalizations were: 520000 COPD, 460000 CHD, and 183000 stroke. CONCLUSIONS: Cardiovascular disease and lung cancer rank high in absolute estimates of disease burden. However, COPD has a more substantial smoking-attributable disease burden. COPD deserves more attention in the health care sector. Smoking cessation programs, pharmacological interruption of the pathophysiology of smoking-related COPD, and effective management of COPD should be key targets of intervention and research.
Cerner Health Insights, Beverly Hills, California, USA 2:
Boehringer Ingelheim GmbH, Ingelheim, Germany
Publication date: December 1, 2004
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The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.
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