Impacto del tabaquismo y del consumo excesivo de alcohol en la mortalidad de la población de la ciudad de Barcelona: 1983-1998.

OBJECTIVES: To analyze the mortality attributable to smoking and alcohol consumption in the city of Barcelona from 1983 to 1998. METHODS: All deaths among residents of the city of Barcelona from 1983 to 1998 were included. Population data were obtained from the city inhabitants register. The mortality attributable to smoking and alcohol consumption was calculated by population attributable fractions using relative risks from previous studies in the US population. RESULTS: In 1998, 2,205 deaths were attributable to smoking, representing 13.8% of all deaths among the population aged 35 years or older and a decrease of 9.6% compared with deaths in 1983. From 1983 to 1998 there was an increase in smoking-attributable adjusted mortality rates for lung cancer (155.84/100,000 inhabitants in men and 9.39/100,000 in women in 1998) and chronic obstructive pulmonary disease (COPD) (95.89/100,000 in men and 11.29/ 100,000 in women in 1998). In 1998, deaths attributed to alcohol consumption accounted for 4.3% of total mortality, representing a reduction of 26% since 1983. Among men, the primary cause of alcohol-attributable mortality was liver cirrhosis (17.1%), although its relative importance decreased (accounting for 17.1% of alcohol-attributable mortality in 1998 compared with 24.3% in 1983). CONCLUSIONS: The mortality attributable to smoking and alcohol consumption decreased in the city of Barcelona during the study period. Smoking-attributable mortality from lung cancer and COPD increased in both sexes. Alcohol consumption-attributable mortality from liver cirrhosis decreased in men.