AUTHOR=Cai Yuzhou , Chen Guiming , Bai Peng 

TITLE=Global, Regional, and National Burden of Smoking-Related Diseases and Associations With Health Workforce Distribution, 1990–2021: Analysis From the Global Burden of Disease Study 2021

JOURNAL=International Journal of Public Health

VOLUME=Volume 70 - 2025

YEAR=2025

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2025.1608217

DOI=10.3389/ijph.2025.1608217

ISSN=1661-8564

ABSTRACT=ObjectivesTo analyze global trends in smoking-related disease burden from 1990–2021 and examine associations with health workforce distribution across countries.MethodsWe analyzed smoking-related deaths and disability-adjusted life years using Global Burden of Disease 2021 data for 204 countries. Age-standardized rates were calculated for 27 geographic regions. Linear regression assessed temporal trends, while autoregressive integrated moving average models projected future burden to 2050. Correlation analyses examined relationships between 22 health workforce categories and disease burden.ResultsGlobally, age-standardized death rates from smoking-related diseases increased by 12.3% from 1990–2021, with males showing higher rates than females across all regions. Middle Socio-demographic Index regions exhibited the highest burden. Pharmaceutical technicians demonstrated strong positive correlations with disease burden (r = 0.35–0.37, p < 0.001), while traditional practitioners showed negative correlations (r = −0.24 to −0.28, p < 0.001). Projections indicate continued increases through 2050.ConclusionSmoking-related disease burden demonstrates significant geographic and temporal variations, with distinct associations between health workforce composition and disease patterns, highlighting the need for targeted prevention strategies.