摘要
目的分析新版《杭州市公共场所控制吸烟条例》(2019)(以下简称《条例》)实施前后居民归因于吸烟和公共场所烟草暴露的脑卒中疾病负担和经济负担。方法本研究为横断面研究,利用2018年和2021年杭州市烟草使用情况调查数据和脑卒中死亡数据,结合2019年全球疾病负担研究(GBD2019)方法,计算因吸烟、公共场所烟草暴露的人群归因分数及伤残调整寿命年(DALY)。结合医疗费用数据和自编问卷调查得到的直接非医疗费用、间接费用数据,计算杭州市归因于吸烟和公共场所烟草暴露的脑卒中疾病经济负担。结果杭州市男性吸烟率从2018年的43.03%降至2021年的34.73%,女性从0.75%升至0.97%;男性公共场所烟草暴露率从53.74%降至35.73%,女性从35.24%降至23.03%。男性归因于吸烟的脑卒中DALY率由92.13人年/10万降至71.04人年/10万;女性归因于吸烟的脑卒中DALY从1.49人年/10万升至1.83人年/10万;男性归因于公共场所烟草暴露的脑卒中DALY率由70.52人年/10万降至45.22人年/10万;女性归因于公共场所烟草暴露的脑卒中DALY率由43.91人年/10万降至29.64人年/10万。2018年杭州市归因于吸烟和公共场所烟草暴露的脑卒中总经济负担分别为39899.63万元、47655.42万元;2021年均有所下降,分别为34944.86万元、33915.70万元。结论新版《条例》的实施在杭州市取得了显著的控烟成效,归因于吸烟和公共场所烟草暴露的脑卒中疾病负担、经济负担均明显减轻。
Objective To analyze the disease burden and economic burden of stroke attributed to smoking and tobacco exposure in public places among residents of Hangzhou before and after the implementation of the regulations on smoking control in public places of Hangzhou City(2019)("Regulations").Methods It was a cross-sectional study.Data were obtained from the tobacco use survey and stroke mortality surveillance system in Hangzhou in 2018 and 2021.Population Attributable Fractions and Disability-Adjusted Life Years(DALYs)attributable to smoking and tobacco exposure in public places were calculated following the methodology framework of the Global Burden of Disease Study 2019(GBD 2019).The economic burden of stroke disease attributable to smoking and tobacco exposure in public places,was calculated based on medical costs,direct non-medical costs and indirect cost data obtained from a self-designed questionnaire.Results The smoking rate in Hangzhou decreased from 43.03% in 2018 to 34.73% in 2021 for males,whereas it marginally increased from 0.75% to 0.97% for females.The tobacco exposure rate in public places decreased from 53.74% to 35.73% for males and from 35.24% to 23.03% for females.The DALY rate for stroke attributable to smoking decreased from 92.13×10^(-5) to 71.04×10^(-5) for males,whereas it increased from 1.49×10^(-5) to 1.83×10^(-5) for females.Similarly,the DALY rate for stroke attributable to tobacco exposure in public places decreased from 70.52×10^(-5) to 45.22×10^(-5) for males and from 43.91×10^(-5) to 29.64×10^(-5) for females.The total economic burden of stroke attributable to smoking and tobacco exposure in public places in Hangzhou City in 2018 was 398.9963 million yuan and 476.5542 million yuan,respectively;both of them decreased to 349.4486 million yuan and 339.1570 million yuan in 2021,respectively.Conclusions The implementation of the new version of the"Regulations"has achieved remarkable tobacco control effects in Hangzhou.The burden of disease and the economic burden of stroke attributable to smoking and exposure to tobacco in public places are significantly reduced.
作者
刘牧文
张欣悦
王勐
马海燕
俞锋
Liu Muwen;Zhang Xinyue;Wang Meng;Ma Haiyan;Yu Feng(Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institute),Hangzhou 310021,China;Hangzhou Normal University,Hangzhou 311121,China)
出处
《中华健康管理学杂志》
北大核心
2025年第6期421-428,共8页
Chinese Journal of Health Management
基金
浙江省医药卫生科技计划项目(2024KY1412)。
关键词
吸烟
卒中
环境和公共卫生
烟草暴露
疾病负担
经济负担
杭州
Smoking
Stroke
Public health and environment
Tobacco exposure
Disease burden
Economic burden
Hangzhou
