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. |