The global, regional and national burden of peptic ulcer disease attributable to smoking from 1990 to 2021: A population-based study.

Background: Peptic ulcer disease (PUD) remains a significant global health challenge, with its prevalence generally declining due to advances in healthcare and reduction in key risk factors. However, smoking continues to be a major contributor to the burden of PUD. This study analyzes the temporal and spatial patterns of PUD burden attributable to smoking globally from 1990 to 2021, providing insights for public health interventions. Methods: Utilizing data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 database, we assessed deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALY rate (ASDR). Trends from 1990 to 2021 were evaluated using average annual percentage change (AAPC), and predictive analyses performed to understand past and future patterns. Results: In 2021, 29,390 deaths and 816,999 DALYs were caused by PUD attributable to smoking worldwide. From 1990 to 2021, deaths, DALYs, ASMR (AAPC: -4.05), and ASDR (AAPC: -4.18) showed significant declines globally. Males experienced a higher burden than females across all metrics. At the national and regional levels, low and low-middle socio-demographic index (SDI) areas exhibited higher ASMR and ASDR than high-SDI regions, with East Asia, South Asia, and Southeast Asia contributing the highest burden. Future projections indicate a continued decline in the burden of PUD attributable to smoking over the next decade. Conclusion: Despite global declines in the burden of PUD attributable to smoking, substantial disparities persist, particularly in underdeveloped regions. Focused anti-smoking policies and targeted resource allocation are necessary to reduce the disease burden and address regional inequalities.