Journal of Preventive Medicine and Public Health

The Korean Society for Preventive Medicine (대한예방의학회)
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Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases

  • Eunsil Cheon (Department of Public Health Science, Graduate School of Public Health, Seoul National University) ;
  • Yeun Soo Yang (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Suyoung Jo (Institute of Health and Environment, Graduate School of Public Health, Seoul National University) ;
  • Jieun Hwang (Department of Health Administration, College of Health Science, Dankook University) ;
  • Keum Ji Jung (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Sunmi Lee (Health Insurance Research Institute, National Health Insurance Service) ;
  • Seong Yong Park (Department of Big Data Management, National Health Insurance Service) ;
  • Kyoungin Na (Division of Climate Change and Health Hazard, Korea Disease Control and Prevention Agency) ;
  • Soyeon Kim (Division of Climate Change and Health Hazard, Korea Disease Control and Prevention Agency) ;
  • Sun Ha Jee (Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University) ;
  • Sung-il Cho (Department of Public Health Science, Graduate School of Public Health, Seoul National University)
  • Received : 2023.10.23
  • Accepted : 2024.05.03
  • Published : 2024.07.31
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Abstract

Objectives: Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Methods: Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. Results: The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Conclusions: Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

Keywords

Acknowledgement

The authors thank the National Health Insurance Service.

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