% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Collaborators:169859, author = {P. J. Kendrick and M. B. Reitsma and M. Abbasi-Kangevari and A. Abdoli and M. Abdollahi and A. Abedi and E. S. Abhilash and V. Aboyans and O. M. Adebayo and S. M. Advani and B. O. Ahinkorah and S. Ahmad and K. Ahmadi and H. Ahmed and B. Aji and Y. Akalu and C. J. Akunna and F. Alahdab and Z. Al-Aly and F. M. Alanezi and T. M. Alanzi and K. F. Alhabib and T. Ali and S. M. Alif and V. Alipour and S. M. Aljunid and M. A. Alomari and T. T. Amin and S. Amini and H. Amu and R. Ancuceanu and J. A. Anderson and C. L. Andrei and T. Andrei and A. Ansari-Moghaddam and B. Antony and D. Anvari and J. Arabloo and N. D. Arian and M. Arora and K. D. Artanti and W. N. Asmare and D. D. Atnafu and M. Ausloos and A. T. Awan and G. Ayano and G. L. Aynalem and S. Azari and D. B. B and A. D. Badiye and A. A. Baig and M. Banach and S. K. Banerjee and S. L. Barker-Collo and T. W. Bärnighausen and H. J. Barqawi and S. Basu and M. Bayati and S. Bazargan-Hejazi and T. T. Bekuma and D. A. Bennett and I. M. Bensenor and H. Benzian and C. P. Benziger and A. E. Berman and A. S. Bhagavathula and N. Bhala and N. Bhardwaj and P. Bhardwaj and K. Bhattacharyya and S. Bibi and A. Bijani and A. Biondi and D. Braithwaite and H. Brenner$^*$ and A. R. Brunoni and K. Burkart and S. Burugina Nagaraja and Z. A. Butt and F. L. Caetano Dos Santos and J. Car and G. Carreras and J. M. Castaldelli-Maia and M. S. S. Cattaruzza and J.-C. Chang and P. Chaturvedi and S. Chen and O. G. Chido-Amajuoyi and D.-T. Chu and S.-C. Chung and L. G. Ciobanu and V. M. Costa and R. A. S. Couto and B. Dagnew and X. Dai and A. A. M. Damasceno and G. Damiani and L. Dandona and R. Dandona and P. Daneshpajouhnejad and J. Darega Gela and M. Derbew Molla and A. A. Desta and S. D. Dharmaratne and M. Dhimal and A. W. Eagan and M. Ebrahimi Kalan and K. Edvardsson and A. Effiong and M. El Tantawi and I. Elbarazi and S. Esmaeilnejad and I. Fadhil and E. J. A. Faraon and M. Farwati and F. Farzadfar and M. Fazlzadeh and V. L. Feigin and R. Feldman and I. Filip and F. Filippidis and F. Fischer and L. S. Flor and N. A. Foigt and M. O. Folayan and M. Foroutan and M. M. Gad and S. Gallus and B. S. Geberemariyam and B. G. Gebregiorgis and L. Getacher and A. Getachew Obsa and M. Ghafourifard and R. Ghanei Gheshlagh and A. Ghashghaee and N. Ghith and G. F. Gil and P. S. Gill and I. A. Ginawi and S. Goharinezhad and M. Golechha and S. V. Gopalani and G. Gorini and M. Grivna and A. Guha and R. A. Guimarães and Y. Guo and R. D. Gupta and R. Gupta and T. Gupta and V. Gupta and N. Hafezi-Nejad and M. R. Haider and R. R. Hamadeh and G. J. Hankey and A. Hargono and S. I. Hay and G. Heidari and C. Herteliu and K. Hezam and T. R. Hird and R. Holla and M. Hosseinzadeh and M. Hostiuc and S. Hostiuc and M. Househ and T. Hsiao and J. Huang and C. U. Ibeneme and S. E. Ibitoye and I. M. Ilic and M. D. Ilic and L. R. Inbaraj and S. S. N. Irvani and J. Y. Islam and R. M. Islam and S. M. S. Islam and F. Islami and H. Iso and R. Itumalla and J. Jaafari and V. Jain and M. Jakovljevic and S.-I. Jang and S. Jayaram and P. Jeemon and R. P. Jha and J. B. Jonas and M. Jürisson and A. Kabir and Z. Kabir and L. R. Kalankesh and T. Kanchan and H. Kandel and N. Kapoor and A. Karch and S. E. Karimi and K. M. Kebede and B. Kelkay and R. D. Kennedy and Y. S. Khader and E. A. Khan and M. Khayamzadeh and G. R. Kim and R. W. Kimokoti and M. Kivimäki and S. Kosen and S. L. Koulmane Laxminarayana and A. Koyanagi and K. Krishan and N. Kugbey and G. A. Kumar and N. Kumar and O. P. Kurmi and D. Kusuma and B. Lacey and I. Landires and S. Lasrado and P. Lauriola and D. W. Lee and Y. H. Lee and J. Leung and S. Li and H. Lin and W. Liu and A. Lugo and S. Madhava Kunjathur and A. Majeed and A. Maleki and R. Malekzadeh and D. C. Malta and A. A. Mamun and N. Manjunatha and B. Mansouri and M. A. Mansournia and S. Martini and M. R. Mathur and P. Mathur and M. Mazidi and M. McKee and C. E. Medina-Solís and S. Mehata and W. Mendoza and R. G. Menezes and B. Miazgowski and I. M. Michalek and T. R. Miller and G. K. Mini and A. Mirica and E. M. Mirrakhimov and H. Mirzaei and S. Misra and Y. Mohammad and A. Mohammadian-Hafshejani and S. Mohammed and A. H. Mokdad and M. Molokhia and L. Monasta and M. A. Moni and R. Moradzadeh and S. D. Morrison and T. B. Mossie and S. Mubarik and E. C. Mullany and C. J. L. Murray and S. P. Nagaraju and M. Naghavi and N. Naik and M. Nalini and V. Nangia and A. A. Naqvi and S. Narasimha Swamy and M. Naveed and J. Nazari and S. O. Nduaguba and R. I. Negoi and S. Neupane Kandel and H. L. T. Nguyen and Y. T. Nigatu and M. R. Nixon and C. A. Nnaji and J. J. Noubiap and C. Nowak and V. Nuñez-Samudio and F. A. Ogbo and A. S. Oguntade and I.-H. Oh and A. T. Olagunju and M. O. Owolabi and M. P A and K. Pakshir and A. Pana and D. Panagiotakos and S. Panda-Jonas and A. Pandey and U. Parekh and E.-C. Park and E.-K. Park and F. Pashazadeh Kan and M. Pathak and S. Pawar and R. G. Pestell and H. Q. Pham and M. Pinheiro and K. N. Pokhrel and A. Pourshams and A. Prashant and A. Radfar and V. Rahimi-Movaghar and M. H. U. Rahman and M. A. Rahman and A. M. Rahmani and P. Ram and J. Rana and C. L. Ranabhat and P. Rathi and D. L. Rawaf and S. Rawaf and R. Rawassizadeh and A. M. N. Renzaho and A. Rezapour and M. A. Riaz and L. Roever and L. Ronfani and G. Roshandel and A. Roy and B. Roy and B. Saddik and A. Sahebkar and S. Salehi and H. Salimzadeh and A. M. Samy and J. Sanabria and M. M. Santric-Milicevic and B. P. Sao Jose and B. Sathian and M. Sawhney and G. K. Saya and F. Schwendicke and A.-A. Seidu and N. Senthil Kumar and S. G. Sepanlou and O. Shafaat and S. M. Shah and M. A. Shaikh and M. Shannawaz and K. Sharafi and A. Sheikh and S. Sheikhbahaei and M. Shigematsu and R. Shiri and K. Shishani and K. M. Shivakumar and S. Shivalli and R. Shrestha and S. Siabani and N. B. Sidemo and I. D. Sigfusdottir and R. Sigurvinsdottir and J. P. Silva and A. Singh and J. A. Singh and V. Singh and D. N. Sinha and V. Y. Skryabin and A. A. Skryabina and A. Soroush and I. N. Soyiri and C. T. Sreeramareddy and D. J. Stein and P. Steiropoulos and S. Stortecky and K. Straif and R. Suliankatchi Abdulkader and G. Sulo and J. Sundström and T. Tabuchi and E. G. Tadesse and A. T. Tamiru and M. Tareke and M. I. Tareque and I. U. Tarigan and B. Thakur and K. R. Thankappan and R. Thapar and M. A. Tolani and M. R. Tovani-Palone and B. X. Tran and J. P. Tripathy and G. W. Tsegaye and H. D. Tymeson and S. Ullah and B. Unim and R. L. Updike and O. A. Uthman and M. Vacante and C. Vardavas and N. Venketasubramanian and M. Verma and S. Vidale and B. Vo and G. T. Vu and Y. Waheed and Y. Wang and K. Welding and A. Werdecker and J. L. Whisnant and N. D. Wickramasinghe and B. L. Wubishet and K. Yamagishi and Y. Yano and V. Yazdi-Feyzabadi and Y. Yeshaw and M. Z. Yimmer and N. Yonemoto and Z. Yousefi and C. Yu and I. Yunusa and H. Yusefzadeh and M. S. Zaman and M. Zamani and M. Zamanian and M. S. Zastrozhin and A. Zastrozhina and J. Zhang and Z.-J. Zhang and C. Zhong and Y. M. H. Zuniga and E. Gakidou}, collaboration = {GBD 2019 Chewing {Tobacco Collaborators}}, title = {{S}patial, temporal, and demographic patterns in prevalence of chewing tobacco use in 204 countries and territories, 1990-2019: a systematic analysis from the {G}lobal {B}urden of {D}isease {S}tudy 2019.}, journal = {The lancet}, volume = {6}, number = {7}, issn = {2468-2667}, address = {London}, publisher = {Elsevier}, reportid = {DKFZ-2021-01593}, pages = {e482 - e499}, year = {2021}, abstract = {Chewing tobacco and other types of smokeless tobacco use have had less attention from the global health community than smoked tobacco use. However, the practice is popular in many parts of the world and has been linked to several adverse health outcomes. Understanding trends in prevalence with age, over time, and by location and sex is important for policy setting and in relation to monitoring and assessing commitment to the WHO Framework Convention on Tobacco Control.We estimated prevalence of chewing tobacco use as part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 using a modelling strategy that used information on multiple types of smokeless tobacco products. We generated a time series of prevalence of chewing tobacco use among individuals aged 15 years and older from 1990 to 2019 in 204 countries and territories, including age-sex specific estimates. We also compared these trends to those of smoked tobacco over the same time period.In 2019, 273·9 million $(95\%$ uncertainty interval 258·5 to 290·9) people aged 15 years and older used chewing tobacco, and the global age-standardised prevalence of chewing tobacco use was $4·72\%$ (4·46 to 5·01). 228·2 million (213·6 to 244·7; $83·29\%$ [82·15 to 84·42]) chewing tobacco users lived in the south Asia region. Prevalence among young people aged 15-19 years was over $10\%$ in seven locations in 2019. Although global age-standardised prevalence of smoking tobacco use decreased significantly between 1990 and 2019 (annualised rate of change: $-1·21\%$ [-1·26 to -1·16]), similar progress was not observed for chewing tobacco $(0·46\%$ [0·13 to 0·79]). Among the 12 highest prevalence countries (Bangladesh, Bhutan, Cambodia, India, Madagascar, Marshall Islands, Myanmar, Nepal, Pakistan, Palau, Sri Lanka, and Yemen), only Yemen had a significant decrease in the prevalence of chewing tobacco use, which was among males between 1990 and 2019 $(-0·94\%$ [-1·72 to -0·14]), compared with nine of 12 countries that had significant decreases in the prevalence of smoking tobacco. Among females, none of these 12 countries had significant decreases in prevalence of chewing tobacco use, whereas seven of 12 countries had a significant decrease in the prevalence of tobacco smoking use for the period.Chewing tobacco remains a substantial public health problem in several regions of the world, and predominantly in south Asia. We found little change in the prevalence of chewing tobacco use between 1990 and 2019, and that control efforts have had much larger effects on the prevalence of smoking tobacco use than on chewing tobacco use in some countries. Mitigating the health effects of chewing tobacco requires stronger regulations and policies that specifically target use of chewing tobacco, especially in countries with high prevalence.Bloomberg Philanthropies and the Bill $\&$ Melinda Gates Foundation.}, cin = {C070}, ddc = {610}, cid = {I:(DE-He78)C070-20160331}, pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)}, pid = {G:(DE-HGF)POF4-313}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:34051920}, pmc = {pmc:PMC8251505}, doi = {10.1016/S2468-2667(21)00065-7}, url = {https://inrepo02.dkfz.de/record/169859}, }