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

Background: The proportion of smokers and the number of cigarettes consumed per person-year in Madrid is above the European average. To evaluate the impact of smoking in public health smoking attributable mortality was estimated for 1998 and for changes since 1992.

Methods: The number of smoking attributable deaths and years of potential life lost attributable to cigarette smoking for 1992 and 1998 by gender and age group were estimated, based on the population attributable fraction. The relative risks of the Cancer Prevention Study II were used. To compare the two periods of study, a Poisson regression analysis adjusted by age was applied.

Results: In 1998, 15.9% of total mortality in the population older than 34 years was attributable to smoking. Lung cancer and chronic obstructive pulmonary disease are the main causes of death in both genders. In the period studied, 1992-1998, the adjusted rates diminished in men in both age groups, while in women they increased in the age group 35 to 64 years. The mortality from lung cancer remained stable in men, increasing in women by 12%. The years of potential life lost decreased by 14% in men and increased by 42% in women.

Conclusions: One in four deaths in men and one in 36 deaths in women are attributed to cigarette smoking. The smoking attributable mortality in males has tended to stabilize, while in women premature mortality is increasing.

Key Points: Smoking attributable mortality was estimated for 1998 and for changes since 1992 to evaluate the impact of smoking in the population older than 34 years.

Main Results: In the period studied, 1992-1998, the adjusted mortality rates attributable to smoking diminished in men, while in women they increased in the age group 35 to 64 years. The main causes of Smoking attributable mortality are Lung cancer and chronic obstructive pulmonary disease in both genders. The mortality from lung cancer remained stable in men, increasing in women by 12%.

Implications For Public Health: In the Community of Madrid, health promotion programmes to reduce cigarette smoking need to be intensified, specially in women.