The impact of smoking on expected lifetime without chronic disease among Palestinian men in the West Bank
Henrik Bronnum-Hansen, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
Marie Jonassen, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Amira Shaheen, Public Health Division, An Najah National University, PalestineMohammed Duraidi, Palestinian Central Bureau of Statistics, Ramallah, Palestine
Khaled Qalalwa, Palestinian Central Bureau of Statistics, Ramallah, Palestine
Bernard Jeune, Institute of Public Health, University of Southern Denmark, Odense, Denmark
Abstract submitted on November 16, 2016 by Henrik Bronnum-Hansen ([email protected])
Background: Smoking is a serious preventable killer and in spite of smokers’ shorter life expectancy, they live on average fewer years in good health than non-smokers do. More than 40 per cent of the West Bank male population are smokers. The purpose of the study was to estimate life expectancy and the average lifetime without and with chronic disease among West Bank male never smokers, ex-smokers, and smokers.
Methods: The study was based on an abridged life table for the West Bank male population. This life table and Danish relative risk estimates for death for moderate smokers (20 or less cigarettes per day), heavy smokers (more than 20 cigarettes per day), and ex-smokers versus never smokers were used to construct life tables for smokers and ex-smokers. Furthermore, the study utilized data on smoking habits and self-reported chronic disease from the Palestinian Family Survey 2010 collected by the Palestinian Central Bureau of Statistics. Life tables and prevalence of chronic disease by age and smoking category for men aged 15 years and older were combined and expected lifetime without and with chronic disease was calculated by Sullivan's method. Finally, the contributions from the mortality effect and the morbidity effect to smoking related difference in average lifetime without and with chronic disease were assessed by decomposition.
Findings Life expectancy of a 15-year-old Palestinian man in the West Bank who will never start smoking was 59.5 years, 41.1 (95% CI: 40.3-41.9) of which were expected to be without
chronic disease. The corresponding figures for a moderate smoking man were 55.6 years, 41.2 (CI: 40.1-42.3) of which were without chronic disease. For lifelong heavy smokers, the expected lifetime was reduced to 52.6 years, of which 38.5 years (CI: 37.3-39.7) were without chronic disease. The estimated average lifetime with chronic disease was 18.4 years (CI: 17.6-19.2) for never smokers, 14.4 years (CI: 13.3-15.4) for moderate smokers, and 14.1 years (CI: 12.9-15.2) for heavy smokers. Ex-smokers could expect 57.9 years of remaining lifetime, 37.7 years (CI: 35.9-39.4) to be spend without disease and 20.2 years (CI: 18.4-22.0) with disease. The mortality effect from the decomposition contributed by 2.5 years of expected lifetime without chronic disease and by 4.4 years with disease to the total loss of 6.9 years of life expectancy of heavy smokers compared to never smokers. The contribution from the morbidity component is negligible (0.06 years without disease). For moderate smokers the mortality effect contributed by 1.6 years without and 2.3 years with chronic disease, whereas the morbidity effect accounted for 1.7 years with chronic disease reflecting that the mortality effect of abstaining from smoking exceeds the gain in expected lifetime without disease by 1.7 years. Comparing ex-smokers with never smokers showed that the mortality effect contributes by 0.5 years without and 1.1 years with chronic disease and the morbidity effect contributed by 2.9 years without disease.
Interpretation Smoking reduces life expectancy and expected lifetime without chronic disease. The health gain from successful interventions against smoking is substantial.

عنوان المؤتمر

8th LPHA Conference

دولة المؤتمر

فلسطين

تاريخ المؤتمر

15 مارس، 2017 - 16 مارس، 2017

راعي المؤتمر

LPHA