Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study

Abstract Background Stroke represents the third most prevalent cause of mortality on a global scale. It is well-documented that smoking constitutes a significant risk factor for stroke, with males accounting for a higher proportion of the global smoking population than females. The present analysis...

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Main Authors: Nan Yang, Tianjun Liu, Huiyan Long, Ruiquan Chen, Zongjun Zhu, Ya Wang, Hongbo Xiao
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-24021-3
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author Nan Yang
Tianjun Liu
Huiyan Long
Ruiquan Chen
Zongjun Zhu
Ya Wang
Hongbo Xiao
author_facet Nan Yang
Tianjun Liu
Huiyan Long
Ruiquan Chen
Zongjun Zhu
Ya Wang
Hongbo Xiao
author_sort Nan Yang
collection DOAJ
description Abstract Background Stroke represents the third most prevalent cause of mortality on a global scale. It is well-documented that smoking constitutes a significant risk factor for stroke, with males accounting for a higher proportion of the global smoking population than females. The present analysis thus focused on the global burden of stroke due to smoking in males over the period 1990–2021, with projections made for future trends in stroke due to smoking in males over the next 20 years. Methods Data concerning the burden of stroke attributable to male active smoking from 1990 to 2021 were retrieved from the Global Burden of Disease Study (GBD) platform. The mean annual percentage change (AAPC) and estimated annual percentage change (EAPC) in age-standardized rates (ASR) of stroke due to male smoking in different regions were calculated as a means of assessing the global disease burden of stroke due to male smoking. To this end, global population projections for 2021–2041 were obtained from realistic and projected demographic databases, and Bayesian age-period-cohort analysis (BAPC) modeling was used to predict future trends in male smoking-attributed stroke over the next 20 years. Results The global age-standardized mortality rate (ASMR) for stroke due to smoking in men exhibited a decline from 33.45/100,000 (95% UI 27.84–39.70) in 1990 to 18.76/100,000 (95% UI 15.23–22.76) in 2021 [EAPC − 1.97 (95% UI -2.03 ~ -1.91)]. The age-standardized disability-adjusted life-years (DALYs) rate (ASDR) for smoking-induced stroke in men exhibited a decline between 1990 and 2021. The burden of smoking-induced stroke was found to be higher among men in the 45 + age group in 2021 compared with 1990. Furthermore, in 2021, the ASMR and ASDR for smoking-induced stroke in men were found to be lowest in high SDI regions. Concurrently, substantial geographic and regional disparities emerged, with the ASMR reaching its peak in East Asia and its nadir in Australasia in 2021. Furthermore, both ASMR and DALYs for male smoking-attributed stroke exhibited a downward trend over the subsequent two decades. Conclusion ASMR and ASDR for stroke due to smoking in men are declining globally, but there are marked differences between different regions of the world and between different age groups of men. It is recommended that future studies focus on developing countries with lower income levels and on smoking men over the age of 45 years to reduce the burden of smoking-related stroke in men.
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spelling doaj-art-df2a944cf1c74f01acaba9ee6c40c42d2025-08-20T03:46:15ZengBMCBMC Public Health1471-24582025-08-0125111310.1186/s12889-025-24021-3Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease StudyNan Yang0Tianjun Liu1Huiyan Long2Ruiquan Chen3Zongjun Zhu4Ya Wang5Hongbo Xiao6The First Affiliated Hospital of Anhui University of Chinese MedicineShandong University of Traditional Chinese MedicineShandong University of Traditional Chinese MedicineThe First Affiliated Hospital of Anhui University of Chinese MedicineThe First Affiliated Hospital of Anhui University of Chinese MedicineThe First Affiliated Hospital of Anhui University of Chinese MedicineThe First Affiliated Hospital of Anhui University of Chinese MedicineAbstract Background Stroke represents the third most prevalent cause of mortality on a global scale. It is well-documented that smoking constitutes a significant risk factor for stroke, with males accounting for a higher proportion of the global smoking population than females. The present analysis thus focused on the global burden of stroke due to smoking in males over the period 1990–2021, with projections made for future trends in stroke due to smoking in males over the next 20 years. Methods Data concerning the burden of stroke attributable to male active smoking from 1990 to 2021 were retrieved from the Global Burden of Disease Study (GBD) platform. The mean annual percentage change (AAPC) and estimated annual percentage change (EAPC) in age-standardized rates (ASR) of stroke due to male smoking in different regions were calculated as a means of assessing the global disease burden of stroke due to male smoking. To this end, global population projections for 2021–2041 were obtained from realistic and projected demographic databases, and Bayesian age-period-cohort analysis (BAPC) modeling was used to predict future trends in male smoking-attributed stroke over the next 20 years. Results The global age-standardized mortality rate (ASMR) for stroke due to smoking in men exhibited a decline from 33.45/100,000 (95% UI 27.84–39.70) in 1990 to 18.76/100,000 (95% UI 15.23–22.76) in 2021 [EAPC − 1.97 (95% UI -2.03 ~ -1.91)]. The age-standardized disability-adjusted life-years (DALYs) rate (ASDR) for smoking-induced stroke in men exhibited a decline between 1990 and 2021. The burden of smoking-induced stroke was found to be higher among men in the 45 + age group in 2021 compared with 1990. Furthermore, in 2021, the ASMR and ASDR for smoking-induced stroke in men were found to be lowest in high SDI regions. Concurrently, substantial geographic and regional disparities emerged, with the ASMR reaching its peak in East Asia and its nadir in Australasia in 2021. Furthermore, both ASMR and DALYs for male smoking-attributed stroke exhibited a downward trend over the subsequent two decades. Conclusion ASMR and ASDR for stroke due to smoking in men are declining globally, but there are marked differences between different regions of the world and between different age groups of men. It is recommended that future studies focus on developing countries with lower income levels and on smoking men over the age of 45 years to reduce the burden of smoking-related stroke in men.https://doi.org/10.1186/s12889-025-24021-3DeathsDisability-adjusted life yearsGlobal burden of diseaseMalesSmokingStroke
spellingShingle Nan Yang
Tianjun Liu
Huiyan Long
Ruiquan Chen
Zongjun Zhu
Ya Wang
Hongbo Xiao
Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
BMC Public Health
Deaths
Disability-adjusted life years
Global burden of disease
Males
Smoking
Stroke
title Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
title_full Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
title_fullStr Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
title_full_unstemmed Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
title_short Global burden of male smoking-induced stroke, 1990–2021, and 20-year projections: an analysis of the 2021 Global Burden of Disease Study
title_sort global burden of male smoking induced stroke 1990 2021 and 20 year projections an analysis of the 2021 global burden of disease study
topic Deaths
Disability-adjusted life years
Global burden of disease
Males
Smoking
Stroke
url https://doi.org/10.1186/s12889-025-24021-3
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