• Andreia Ferreira Oliveira, Joaquim Gonçalves Valente, and Iuri Costa Leite.
• Department of Epidemiology and Quantitative Health Methods, National School of Public Health, FIOCRUZ, Rio de Janeiro, RJ, Brazil. andreiaf@ensp.fiocruz.br
• Clinics (Sao Paulo). 2008 Apr 1; 63 (2): 215222215-22.

IntroductionSmoking is one of the main risk factors for morbidity and mortality. An estimated 59 million (4.4%) disability-adjusted life years were lost due to smoking throughout the world in 2000.ObjectiveTo estimate the disease burden attributable to smoking in the State of Rio de Janeiro, Brazil, for the year 2000.MethodsBased on estimates of smoking prevalence and relative death risks, the smoking-attributable fraction was calculated for each selected cause, by age and gender. The disease burden attributable to smoking was estimated by multiplying the fractions by the corresponding disability-adjusted life years.ResultsIn the State of Rio de Janeiro, 7% of all disability-adjusted life years were due to smoking. For individuals 30 or more years old, the fraction increased to 10.6% (13.6% in males and 7.5% in females). Chronic obstructive pulmonary disease, ischemic heart disease, cerebrovascular disease, and tracheal, bronchial, and lung cancer accounted for 32.2%, 15.7%, 13.2%, and 11.1% of the estimated total DALYs, respectively, amounting to 72.2% of the smoking-attributable disease burden.DiscussionLimitations related to parameter estimates were not unique to this study, and therefore should not compromise the comparability of our results. Outcomes were similar to those obtained in other countries, despite methodological differences.ConclusionSmoking is an important risk factor and places a significant disease burden on Rio de Janeiro, Brazil, showing a pattern similar to that observed in high income countries.

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