Disease burden and changing trend of tracheal, bronchus, and lung cancer attributable to tobacco, globally and in China, the USA, the Russian Federation, and India, 1990-2021.

Background: The disease burden of tobacco-related tracheal, bronchus, and lung cancer (TBL) in China, the USA, the Russian Federation, and India is a global problem that cannot be ignored because of their vast populations. We analyzed disease burden trends in these nations and worldwide to inform effective control strategies. Methods: The Global Burden of Disease 2021 (GBD 2021) database was used to extract and integrate data on the burden of TBL attributable to tobacco for global regions, as well as for China, the USA, the Russian Federation, and India, from 1990 to 2021. Trends in the disease burden were analyzed using Joinpoint 4.9.1.0 software. To project future disease burden trends for the period 2022-2031, the Bayesian age-period-cohort (BAPC) model was applied to estimate the impact of tobacco-related TBL globally and in the selected countries. Results: From 1990 to 2021, the age-standardized mortality rate (ASMR), age-standardized disability-adjusted life years rate (ASDR) of TBL attributable to tobacco showed a decreasing trend globally and in the USA, the Russian Federation, and India, and the ASMR and ASDR attributable to TBL caused by tobacco use have shown an upward trend in China. Compared with the global average, the burden of disease of TBL attributable to tobacco is much higher in China than in the USA, the Russian Federation, and India from 1990 to 2021. By gender, the disease burden of TBL attributable to tobacco is much higher for male patients than for female patients in 1990-2021 globally and in China, the USA, the Russian Federation, and India. As of 2021, the elderly population aged 60 years or older is the main group with the disease burden of TBL attributable to tobacco globally and in the USA, the Russian Federation, and India. As the Social Development Index (SDI) level rises, the decreasing trend in ASDR and ASMR is more pronounced. Decomposition analyses showed that the increase in ASMR and ASDR globally, in China, the USA, and India, was mainly caused by population growth, and epidemiological trends, and population growth mainly caused the increase in ASMR and ASDR in the Russian Federation. The BAPC prediction model showed that the ASMR and ASDR of TBL attributable to tobacco globally and in China, the USA, the Russian Federation, and India from 2022 to 2031 showed a decreasing trend. Conclusions: Over the past three decades, tobacco-attributable TBL disease burden has declined globally and in the USA, the Russian Federation, and India, but continues rising in China, where male and elderly populations (60+ years) bear disproportionately high burdens. Projections suggest declining trends across all regions in the next decade, though targeted interventions for high-risk demographics remain critical.