ArticleTobacco induced diseases2026
Global burden of lower extremity peripheral arterial disease attributable to smoking from 1990 to 2021: A secondary dataset analysis of the Global Burden of Disease Study 2021.
Article in Tobacco induced diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionSmoking is the primary modifiable risk factor for lower extremity peripheral arterial disease (LEPAD). This study aimed to assess the global spatiotemporal trends of LEPAD burden attributable to smoking and disentangle the underlying drivers.
methodsThis study is a secondary analysis of publicly available data from the Global Burden of Disease (GBD) 2021 study. We analyzed mortality and disability-adjusted life years (DALYs) across 204 countries and territories from 1990 to 2021. Trends were evaluated using estimated annual percentage change (EAPC), joinpoint regression, and age-period-cohort (APC) models.
resultsIn 2021, the global number of deaths and disability-adjusted life years (DALYs) due to LEPAD attributable to smoking reached 14130.84 (95% UI: 10300.51-18587.81) and 439653.32 (95% UI: 306683.31-602207.38), respectively, representing increases of 32.25% and 41.01% since 1990, largely driven by population aging. Conversely, the age-standardized mortality rate (ASMR) decreased by 47.25% to 0.16 per 100000, and the age-standardized DALY rate (ASDR) decreased by 40.94% to 5.01 per 100000. Males bore approximately 3.5 times the mortality burden of females (10986.02 vs 3144.82 deaths), and the highest rates were observed in Eastern Europe and Central Asia. EAPC analysis showed a negative correlation with the sociodemographic index (SDI), indicating rising trends in some low SDI regions. The APC analysis revealed that while risk escalated exponentially with age, favorable period and cohort effects drove the decline in rates.
conclusionsAlthough age-standardized rates have declined globally due to tobacco control and medical advancements, the absolute burden of smoking-attributable LEPAD continues to rise. Targeted interventions focusing on high-risk regions and aging populations should be considered to mitigate this growing challenge.
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