Objectives: The objectives are to confirm the secular changes in smoking rate in each prefecture and in the whole country of Japan, and to ecologically examine the associations between secular changes in smoking rate and those in death rates from selected major causes among prefectures in Japan.
Methods: The data of smoking rate (SR) and cause-specific death rate (CSDR) were collected from e-Stat, which is a portal site of official statistics of Japan. The age-standardized SR and CSDR (standardized to the 2015 model population) were calculated between 2001-2019. The average annual percent changes (AAPCs) of age-standardized SR and CSDR in each prefecture and in the whole country of Japan were investigated from 2001 to 2019. Then, the associations between AAPC of the age-standardized SR and the AAPCs of age-standardized CSDR from selected major causes, were examined as an ecological study with all prefectures.
Results: Age-standardized SR in the whole country significantly decreased after 2001 in both genders. Age-standardized SR significantly decreased after 2001 in all prefectures in men, however in women it significantly decreased in prefectures excluding Aomori, Tottori, Saga, and Kagoshima prefectures. The associations between the age-standardized SR and CSDR among the prefectures were that the larger the average annual decreasing rates of age-standardized SR, the larger the average annual decreasing rates of age-standardized death rates from all-cause, malignant neoplasms, and cerebrovascular diseases in both genders.
Conclusion: The AAPC of age-standardized SR and AAPCs of the age-standardized death rates from all-cause, malignant neoplasms, and cerebrovascular diseases were significantly positively correlated among prefectures in both genders. Our analysis method would be one of the methods to confirm the association between secular changes in cause and result.
