Türkiye’de toplumda sigara içme sıklığı nasıl değişiyor?

Abstract

Amac: Sigara icme sikligi ile ilgili epidemiyolojik bilgi en uygun girisimin belirlenmesi ya da girisimin etkinliginin degerlendirilmesi icin onemlidir. Bu calismanin amaci, Turkiye’de eriskinlerde sigara icme sikligi konusunda yapilan arastirmalarin elestirel degerlendirmesini yapmak ve secilmis bazi calismalarin sonuclarina dayanarak Turkiye’de 2015 yili icin beklenen sigara icme sikligini hesaplamaktir. Yontem: Bu sistematik derlemede calismalar, uluslararasi ve ulusal elektronik veri tabanlarindan taranmistir. Medline’da ‘smoking’ ‘prevalence’ ve ‘Turkey’ anahtar sozcukleriyle ulasilan 690 calismadan yedisinin ULAKBIM’deki 86 calismadan yedisin, YOK tez veritabanindaki 78 calismadan ikisinin sigara verisinin oldugu saptanmistir. Tezler, kongre bildirileri, halk sagligi ve gogus hastaliklari dernek web siteleri, bazi makalelerin kaynak listeleri elle taranmis, uzmanlara danisilmis, ulusal arastirma raporlari incelenmistir. Toplam 31 calisma degerlendirilmistir.Calismalardan kriterlere uygun olan dordunun verisi kullanilarak dogrusal regresyon esitlikleri olusturulmus ve 2015 yili icin beklenen sigara icme sikliklari hesaplanmistir. Bulgular: Turkiye’de sigara icme sikligini belirlemeye yonelik ilk calismalar 1988, 1993’te yapilmis, en son 2010 TURDEP II verisine ulasilmistir. Incelenen calismalarin ornek buyuklukleri 246 ile 26546 arasinda degismektedir. Arastirmalarin besi sadece kadinlari kapsamaktadir. Arastirmalarda sigara icme icin farkli tanimlamalar kullanilmistir. Degerlendirmeye alinan 1988–2010 yillari arasinda yapilmis olan 31 calismada sigara icme sikligi erkeklerde %27.5–63.8, kadinlarda %8.4–27.8 arasinda degismektedir. Turkiye’de sigara icme sikligi 1997 yilindan 2010 yilina kadar erkeklerde yilda %1.33 azalirken, kadinlarda ise degismemistir. Turkiye’de 1997–2010 arasi gozlenen egilim devam ederse 2015 yilinda 25 yas uzeri erkeklerde sigara icme sikliginin %18.8 (%95GA: 11.2–26.3), kadinlarda %9.06 (%95GA: 9.03–9.09) olmasi beklenebilir. Sonuc: Turkiye’de toplumda sigara icme sikligini belirlemeye yonelik calismalarin daha cok bolgesel yapildigi ve sigara icme taniminin ortak olmadigi gorulmustur. Sigara icmenin epidemiyolojik ozelliklerinin yillar icindeki degisimini degerlendirmek icin ulusal boyutta, karsilastirilabilir yontemlere dayanan ve belli aralarla tekrarlanan calismalara gereksinim vardir. Var olan calismalara gore sigara icme sikliginin erkeklerde azalma egiliminde oldugu dikkati cekmektedir. Anahtar Kelimeler: Sigara icme sikligi, sistematik derleme, regresyon Anahtar Kelimeler: Sigara icme sikligi, sistematik derleme, regresyon How has the prevalence of smoking changed in Turkey? Abstract Objective: Epidemiological data on the prevalence and determinants of smoking are important for determining  the most suitable intervention methods and for evaluating the effectiveness of these interventions. The aim of this study was to identify and appraise studies on smoking prevalence in order to determine the trends and make projections for the year 2015 in Turkey. Method: In this systematic review, cross-sectional studies or surveys on smoking prevalence were searched from national and international electronic databases using the keywords “smoking or tobacco”, “prevalence” and “Turkey” without a time limit (n=690). Seven out of  86 studies  from the ULAKBIM database and two of 78 studies from the  YOK thesis database  had data on smoking. Additionally, theses and congress presentations, Websites of the Turkish Society of Public Health Specialists and the Turkish Thoracic Society and reference lists of articles were manually searched. Experts were consulted; National research reports were also evaluated. In total 31 studies were assessed. Four national studies were chosen for linear regression analysis to predict smoking prevalence in 2015. Results: The earliest studies on the prevalence of smoking in Turkey were conducted in 1988 and in 1993; and the latest was conducted in 2010. - Samples sizes ranged between 246 and 26546. Smoking prevalence ranged from 27.5% to 63.8% in men and 8.4% to 27.8% in women in 31 studies. Smoking prevalence in men over 25 years of age decreased 1.33 % annually between 1997-- 2010, in women prevalences did not change. If the same linear trend goes on, then the expected smoking prevalence would be 18.8% (95%CI: 11.2-26.3) in men and 9.06%( 95%CI: 9.03-9.09) in women aged over 25 in 2015. Conclusion: In Turkey, the number of national studies on the epidemiology of smoking are limited. Smoking prevalence has been declining especially in men in Turkey. Recent tobacco control strategies may sustain or even accelerate this trend. However good quality, nationally representative, periodic epidemiologic research with comparable methods on the extent and determinants of smoking should be supported. Key Words : Smoking prevalence, systematic review, regression, Turkey