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Table 1 Methods used to estimate tobacco attributable mortality

From: Methodologies used to estimate tobacco-attributable mortality: a review

Method

Data employed

Data source

Method applied to estimate mortality due to:

Weaknesses

Strengths

Estimations calculated

Prevalence-based analysis in cohort studyes/SAMMEC (n = 52)

Prevalence

National Statistics

Tobacco consumption, exposure to environmental tobacco smoke (ETS), obesity, alcohol intake,...

- Does not take latency into account.

- Worldwide use.

Attributable mortality for all causes.

 

Relative Risks: Smokers, non-smokers and former smokers

Cohort study

  

- Application of risks other than CPS.

 

Method proposed by Peto and colleagues (n = 6)

Relative Risks: Smokers and non-smokers

CPS II

Tobacco consumption.

- Assumes constant worldwide lung cancer mortality rates among never smokers.

- Worldwide use.

Attributable mortality for all causes.

 

Lung cancer death rates: Global (non smokers + smokers + former smokers), non-smokers and smokers.

National Statistics/CPS II

 

- Assumes the same latency for all death causes related to tobacco.

- Mortality estimation in absence of smoking prevalence.

 
    

- Does not take into account former smokers.

- Takes latency into account for lung cancer.

 

Basic method (n = 1)

Lung cancer death rates

National Statistics

Tobacco consumption.

- Partial view of attributable mortality (only used to estimate mortality by lung cancer).

- Takes into account induction time.

Lung cancer death rate attributable and not attributable to active smoking.

 

Prevalence

National statistics/Estimated

 

- Use of constants.

- Estimates smoking-adjusted RR in different time periods.

 
 

Lung cancer relative risk

Calculated

 

- High need of information.

  
 

Packs of cigarettes smoked

National statistics/Estimated

 

- Rate ratios for former smokers.

  
 

Age of starting/giving up tobacco consumption

National statistics/Estimated

 

- Assumes constant worldwide lung cancer mortality rates among never smokers.

  
 

Constants

Previous studies

    

Prevent method (n = 2)

Composition of the population

National Statistics

Tobacco consumption and general scenarios of effective health promotion.

- High need of information.

-Takes into account the multiplicity of cause or effect.

Attributable mortality for all causes.

 

Mortality (population) and birth (women) rates

National Statistics

  

- Proportional decrease in risk reduction related to time.

 
 

Latency and delay

Previous studies

  

- To measure the results of intervention policies.

 
 

Time-Tendency of tobacco consumption.

Personal interviews

    
 

Relative risks

CPS II

    

Prevalence-based analysis in case-control studyes (n = 4)

Mortality observed

National Statistics

Tobacco consumption and exposure to ETS.

- Case-control study design.

- Specific risk dates.

Attributable mortality for all causes.

 

Exposure prevalence: case or controls

Case-control study

 

- Recall bias.

  
 

Odds Ratios

Case-control study

    

Garfinkel's method (n = 2)

Mortality observed

National Statistics

Tobacco consumption and alcohol intake.

- Partial view of the attributable mortality (only used to estimate cancer mortality).

- Necessary dates are few.

Cancer deaths attributable to smoking.

 

Cancer mortality rates in non smokers.

American Cancer Society

 

- Assumes constant worldwide cancer mortality rates among never smokers.

- Does not use risks or prevalence.

 

Rogers' method (n = 1)

Mortality observed (all causes)

National Statistics

Tobacco consumption.

- Availability of mortality registries.

- Risks calculated ad hoc.

Attributable mortality for all causes.

 

Prevalence (7 categories)

Surveys

 

- Has a population representative survey about health-risks.

- The population division is more reliable.

 
 

Odds Ratios

Discrete-time hazard models

 

- Assumption: smoking status remains steady since the survey about health-risks.

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