Trends and Association between Smoking and the Socio-Demographic Index Among 11 South American Countries, 1990-2019

To examine prevalence trends in the use of smoked tobacco products in 11 South American (SA) countries (i.e., Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Paraguay, Peru, Suriname, Uruguay, and Venezuela) and their association with country-specific socio-demographic index (SDI) over 30 years.

The estimates of SDI and smoked tobacco prevalence stratified by age, sex, and country were extracted from the Global Burden of Disease Study (1990-2019) on individuals aged 15+. The annual percentage changes (APCs) of trends in country-specific prevalence of smoked tobacco were evaluated using Joinpoint regression. Correlation analysis was also used to explore the association between country-specific prevalence of smoked tobacco and their SDIs, a measure of developmental status considering income per capita, educational attainment, and total fertility rate.

While all SA countries showed an overall decline in smoked tobacco use prevalence between 1990 and 2019 (APCs between -0.52%-and -4.73%; p < 0.05), Bolivia and Ecuador showed a significant increasing trend (APCs of 0.34% and 0.20%). Country-specific SDI was strongly and significantly correlated (rs = -0.99 to -0.85) with smoking prevalence in SA countries, except for Ecuador and Bolivia (rs = 0.16 and 0.36, respectively).

In recent decades, most SA countries have experienced a significant reduction in the prevalence of smoked tobacco use, except Ecuador and Bolivia, where smoking rates have risen, showing a direct correlation with SDI. These findings can contribute to the design and implementation of strategies and policies for tobacco prevention and control in the SA region especially within the two affected countries - Ecuador and Bolivia.