The aim of this study was to estimate smoking-attributable mortality (SAM) in the population aged 35 years and over in Brazil's 27 federal units by sex, in 2019. This is an attributable mortality analysis. We applied a method dependent on the prevalence of smoking, based on the population attributable fractions. Data on mortality due to causes causally related to smoking were derived from Brazil's Death Registry, data on prevalence of smoking from a survey conducted in Brazil in 2019, and data on relative risks from five US cohorts. Crude and age-adjusted SAM rates were calculated by sex. Estimates of SAM were calculated by specific causes of death and major mortality groups for each federal unit by sex. In 2019, smoking caused 480 deaths per day in Brazil. Although the SAM varied among the federal units, the pattern is not clear, with the greatest difference being between Rio Grande do Sul (crude rate: 248.8/100,000 inhabitants) and Amazonas (106.0/100,000). When the rates were adjusted by age, the greatest differences were observed between Acre (271.1/100,000) and Distrito Federal (131.1/100,000). SAM was higher in males; however, while the main specific cause of SAM in men was ischemic heart disease, in women it was chronic obstructive pulmonary disease. The major mortality group having the greatest impact on SAM across all federal units was the cardiometabolic diseases. The variability in the burden of SAM in the different regions of Brazil reaffirms the need for SAM data disaggregated at the geographic level.

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巴西 27 个联邦单位按性别划分的吸烟死亡率：2019 年

本研究的目的是估算 2019 年巴西 27 个联邦单位按性别划分的 35 岁及以上人口的吸烟归因死亡率 (SAM)。这是一项归因死亡率分析。我们采用了一种依赖于吸烟率的方法，该方法基于人口归因分数。与吸烟相关的死亡数据来自巴西的死亡登记处、2019 年在巴西进行的一项调查的吸烟流行率数据以及来自美国五个队列的相对风险数据。粗略和年龄调整的 SAM 率按性别计算。 SAM 的估计值是根据每个联邦单位的具体死亡原因和主要死亡群体（按性别）计算的。 2019年，巴西每天因吸烟导致480人死亡。尽管 SAM 在联邦单位之间有所不同，但模式并不明确，最大的差异是南里奥格兰德州（原油比率：248.8/100,000 居民）和亚马逊州（106.0/100,000 居民）之间。当按年龄调整比率时，在阿卡 (271.1/100,000) 和联邦区 (131.1/100,000) 之间观察到最大差异。男性的 SAM 较高；然而，男性 SAM 的主要具体病因是缺血性心脏病，而女性 SAM 的主要具体病因是慢性阻塞性肺病。对所有联邦单位的 SAM 影响最大的主要死亡类别是心脏代谢疾病。巴西不同地区 SAM 负担的差异再次证明需要在地理层面上分解 SAM 数据。