Trends in smoking-attributable cardiovascular mortality in Germany

Area of Science:

• Public Health
• Epidemiology
• Cardiovascular Disease Research

Background:

• Smoking remains a significant risk factor for cardiovascular diseases globally.
• Understanding the trends in smoking-attributable mortality is crucial for public health interventions.
• Population aging can influence the interpretation of mortality trends.

Purpose of the Study:

• To quantify the fraction of cardiovascular deaths attributable to smoking in Germany between 1992 and 2021.
• To account for the impact of population aging on these trends.
• To project future trends in smoking-attributable cardiovascular mortality.

Main Methods:

• Calculation of population-attributable fractions for smoking-related cardiovascular deaths.
• Comparison of actual mortality figures with age-standardized rates.
• Analysis of temporal trends from 1992 to 2021 and forward projections.

Main Results:

• A substantial decrease in the absolute number of cardiovascular deaths attributable to smoking was observed, from approximately 71,900 in 1992 to 42,000 in 2021.
• The decline was more pronounced in men.
• Age-standardization revealed that population aging partially offset the observed decline.

Conclusions:

• Despite a significant reduction in smoking-attributable cardiovascular deaths, population aging complicates the trend interpretation.
• Future projections indicate a potential increase in these deaths over the next decade.
• Targeted smoking cessation programs are essential to mitigate future cardiovascular mortality burdens.