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IMPACT OF SMOKING ON COPD DEATH IN TAIWAN AND FORECASTING MORTALITY TO 2025

Background and Aims: The aim of the WHO 25 by 25 goal is to reduce mortality from premature non-communicable diseases by 25% before 2025. Tobacco smoking is not only the leading preventable cause of death in the world but also leading cause of chronic obstructive pulmonary disease (COPD). The aim of this study is to estimate the 25 by 25 goal for premature mortality from COPD and the smoking attributable COPD death in Taiwan. Methods: This is a National population-based study. Records of premature deaths due to COPD from 1990 to 2014 in Taiwan were abstracted from the database provided by the Ministry of Health and Welfare. Data for the age-specific prevalence of smoking were taken from the database, Taiwanese Adult Smoking Behaviour Surveillance System, provided by the Health Promotion Administration in Taiwan. We applied the age-period-cohort model to evaluate the trends and patterns of incidence and mortality of COPD and also to project the incidence of premature death from COPD from 2015 to 2024. We used the population attributable fraction to estimate the contribution of smoking in premature death from COPD. Results: The age-period-cohort effect of smoking attributable COPD mortality in Taiwan was shown in the figure. Based on different case scenarios (no change, usual care and 30% reduction in smoking prevalence), the forecasting smoking attributable COPD mortality in Taiwan were 295*10, 267*10, 256*10 in men and 58.3*10, 57.8*10, 57*10 in women, respectively. Compared with the assumption of no change in smoking prevalence, an estimated of 326, 455 men and 6, 16 women would be saved under usual care and 30% reduction in smoking prevalence, respectively. Conclusion: Strictly restriction on tobacco use, especially in men, is necessary for reduction of the forecasting smoking attributable COPD mortality in Taiwan. AP450