Background Alcohol consumption and tobacco use are the primary risk factors contributing towards Non-Communicable Disease (NCD) mortality and morbidity worldwide. However, it is important to comprehensively estimate the combined burden of Cancer and CVD attributable to the independent effects of these two risk factors in Ireland to inform national health policy making.
Methods We accessed publicly available data from the IHME (Institute of Health metrics and evaluation) website on Cancer and CVD (Strokes and Ischaemic Heart Disease (IHD)), including data on tobacco use and alcohol consumption for two calendar years: 1990 and 2013. Death rates, Disability Adjusted Life Years (DALYs), and Years Lived with Disability (YLDs) from these two NCDs attributable to the selected risk factors were estimated as follows:
Years-of-life lost due to premature mortality (YLLs) = Total deaths at each age * reference life expectancy at that age;
YLDs = prevalence * disability weight;
DALYs = YLDs + YLLs;
All estimates were based on total disease conditions and risk factors, thus analysed in the Global Burden of Disease study.
Results Combined cancer and CVD death rates (per 100,000) attributable to tobacco use were five-fold higher (98.1) compared to death rates attributable to alcohol consumption (20.3) in 1990. However, such population attributable death rates declined by ≈25% for tobacco use (74.9) compared to a larger decline of >50% due to alcohol consumption (9.7) in 2013.
Combined cancer and CVD related DALYs (per 100,000) attributable to tobacco use were nine-fold higher (2031.4) compared to the DALYs attributable to alcohol consumption (234.6) in 1990. However, the DALYs declined by 32% for tobacco use (1379.6) compared to a smaller decline of 13% due to alcohol consumption (204.1) in 2013.
Combined cancer and CVD related YLDs (per 100,000) attributable to tobacco use were six-fold higher (53.7) compared to the YLDs attributable to alcohol consumption (8.8) in 1990. However, the YLDs increased by a similar magnitude of ≈40% both for tobacco use (74.9) and alcohol consumption (12.5) in 2013.
Specifically, breast cancer and lung cancer attributable to alcohol consumption and tobacco use, respectively, noted the highest death rates and DALYs for both the calendar years.
Conclusion Tobacco use still contributes significantly to cancer and CVD burden in Ireland compared to alcohol consumption. Despite a faster and a large improvement in alcohol-attributable NCD death rates, there has been a recent increase in years lived with disability for both these population risk factors.