000293937 001__ 293937 000293937 005__ 20250814110842.0 000293937 0247_ $$2doi$$a10.1016/S2468-2667(24)00166-X 000293937 0247_ $$2altmetric$$aaltmetric:168901692 000293937 0247_ $$2pmid$$apmid:39366729 000293937 037__ $$aDKFZ-2024-02004 000293937 041__ $$aEnglish 000293937 082__ $$a610 000293937 1001_ $$aBryazka, Dana$$b0 000293937 245__ $$aForecasting the effects of smoking prevalence scenarios on years of life lost and life expectancy from 2022 to 2050: a systematic analysis for the Global Burden of Disease Study 2021 000293937 260__ $$aLondon$$bElsevier$$c2024 000293937 3367_ $$2DRIVER$$aarticle 000293937 3367_ $$2DataCite$$aOutput Types/Journal article 000293937 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1728310789_25703 000293937 3367_ $$2BibTeX$$aARTICLE 000293937 3367_ $$2ORCID$$aJOURNAL_ARTICLE 000293937 3367_ $$00$$2EndNote$$aJournal Article 000293937 520__ $$aBackground: Smoking is the leading behavioural risk factor for mortality globally, accounting for more than 175 milliondeaths and nearly 4·30 billion years of life lost (YLLs) from 1990 to 2021. The pace of decline in smoking prevalencehas slowed in recent years for many countries, and although strategies have recently been proposed to achievetobacco-free generations, none have been implemented to date. Assessing what could happen if current trends insmoking prevalence persist, and what could happen if additional smoking prevalence reductions occur, is importantfor communicating the effect of potential smoking policies.Methods: In this analysis, we use the Institute for Health Metrics and Evaluation’s Future Health Scenarios platformto forecast the effects of three smoking prevalence scenarios on all-cause and cause-specific YLLs and life expectancyat birth until 2050. YLLs were computed for each scenario using the Global Burden of Disease Study 2021 referencelife table and forecasts of cause-specific mortality under each scenario. The reference scenario forecasts what couldoccur if past smoking prevalence and other risk factor trends continue, the Tobacco Smoking Elimination as of 2023(Elimination-2023) scenario quantifies the maximum potential future health benefits from assuming zero percentsmoking prevalence from 2023 onwards, whereas the Tobacco Smoking Elimination by 2050 (Elimination-2050)scenario provides estimates for countries considering policies to steadily reduce smoking prevalence to 5%. Together,these scenarios underscore the magnitude of health benefits that could be reached by 2050 if countries take decisiveaction to eliminate smoking. The 95% uncertainty interval (UI) of estimates is based on the 2·5th and 97·5th percentileof draws that were carried through the multistage computational framework.Findings: Global age-standardised smoking prevalence was estimated to be 28·5% (95% UI 27·9–29·1) among malesand 5·96% (5·76–6·21) among females in 2022. In the reference scenario, smoking prevalence declined by 25·9%(25·2–26·6) among males, and 30·0% (26·1–32·1) among females from 2022 to 2050. Under this scenario, weforecast a cumulative 29·3 billion (95% UI 26·8–32·4) overall YLLs among males and 22·2 billion (20·1–24·6) YLLsamong females over this period. Life expectancy at birth under this scenario would increase from 73·6 years (95% UI72·8–74·4) in 2022 to 78·3 years (75·9–80·3) in 2050. Under our Elimination-2023 scenario, we forecast 2·04 billion(95% UI 1·90–2·21) fewer cumulative YLLs by 2050 compared with the reference scenario, and life expectancy atbirth would increase to 77·6 years (95% UI 75·1–79·6) among males and 81·0 years (78·5–83·1) among females.Under our Elimination-2050 scenario, we forecast 735 million (675–808) and 141 million (131–154) cumulative YLLswould be avoided among males and females, respectively. Life expectancy in 2050 would increase to 77·1 years(95% UI 74·6–79·0) among males and 80·8 years (78·3–82·9) among females.Interpretation: Existing tobacco policies must be maintained if smoking prevalence is to continue to decline asforecast by the reference scenario. In addition, substantial smoking-attributable burden can be avoided byaccelerating the pace of smoking elimination. Implementation of new tobacco control policies are crucial in avoidingadditional smoking-attributable burden in the coming decades and to ensure that the gains won over the pastthree decades are not lost. 000293937 536__ $$0G:(DE-HGF)POF4-313$$a313 - Krebsrisikofaktoren und Prävention (POF4-313)$$cPOF4-313$$fPOF IV$$x0 000293937 588__ $$aDataset connected to CrossRef, Journals: inrepo02.dkfz.de 000293937 7001_ $$aReitsma, Marissa B$$b1 000293937 7001_ $$aAbate, Yohannes Habtegiorgis$$b2 000293937 7001_ $$aAbd Al Magied, Abdallah H A$$b3 000293937 7001_ $$aAbdelkader, Atef$$b4 000293937 7001_ $$aAbdollahi, Arash$$b5 000293937 7001_ $$aAbdoun, Meriem$$b6 000293937 7001_ $$aAbdulkader, Rizwan Suliankatchi$$b7 000293937 7001_ $$aAbeldaño Zuñiga, Roberto Ariel$$b8 000293937 7001_ $$aAbhilash, E. 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