摘要目的:分析2010—2019年天津市死亡居民的吸烟率变化趋势及主要死亡原因构成。方法:研究基于2010—2019年天津市居民全死因监测系统中的收集的数据，共计699 372例纳入本研究；依据研究对象不同死亡年份、性别进行分组计算吸烟率、戒烟率及不吸烟率；依据研究人群的出生年份、性别进行分组计算吸烟程度比例；依据年龄段进行分组描述吸烟者死于吸烟相关疾病的分布情况。采用Joinpoint 4.9.0.0回归软件分析吸烟率变化趋势；采用构成比描述吸烟者主要死亡原因构成。结果:2010—2019年死亡居民吸烟率由28.7%降至21.4%，平均年度变化百分比（AAPC）为-3.0%（95% CI：-3.9%~-2.2%），不同性别死亡居民呈现同样趋势；戒烟者比例呈现上升趋势，由2010年的10.5%升至2019年的14.7%，AAPC为3.8%（95% CI：1.7%~6.0%）；轻度吸烟者的比例随出生年份的后推而增加，1950年及之前出生的轻度吸烟者比例为14.7%，1981年及之后出生的轻度吸烟者比例则高达85.9%；重度吸烟者比例则随出生年份的后推而减少；肺癌和心脑血管疾病是吸烟者和戒烟者的主要死因，戒烟者中13.86%死于肺癌，稍低于吸烟者（16.39%），均显著高于不吸烟者（5.55%），而吸烟者中随着吸烟程度的升高，死于肺癌的比例也逐渐升高，由9.19%升至19.11%。 结论:2010—2019年天津市死亡居民的吸烟率呈下降趋势，与天津市居民整体吸烟率变化趋势一致。肺癌、急性心肌梗死、缺血性心脏病位居吸烟者主要死因构成的前3位。

abstractsObjective:To evaluate the change trend of smoking prevalence and the composition of main causes of death in Tianjin from 2010 to 2019.Methods:The study was based on the data collected in the Tianjin All Cause of Death Surveillance System from 2010 to 2019. A total of 699 372 cases were included in the study. The smoking prevalence, ex-smoking and never smoking prevalence were calculated according to different death years and gender. The proportion of smoking status was calculated according to the year of birth and gender. The distribution of smokers dying of smoking related diseases were calculated by different age-group. The change trend of smoking rate was analyzed by Joinpoint regression 4.9.0.0 statistical software. The diseases that smokers died of were expressed by proportion.Results:From 2010 to 2019, the smoking rate of dead residents decreased from 28.7% to 21.4%, and the average annual change percentage (AAPC) was -3.0% (95% CI: -3.9%, -2.2%). The same trend was shown in dead residents of different genders. The proportion of ex-smokers showed an upward trend, from 10.5% in 2010 to 14.7% in 2019; The proportion of light smokers increased with the postponement of birth year. The proportion of light smokers born at and before year 1950 was 14.7%, while the proportion of light smokers born at and after year 1981 was as high as 85.9%; the proportion of heavy smokers decreased with the year of birth. Lung cancer and cardiovascular and cerebrovascular diseases were the main causes of death of smokers and quitters. 13.86% of quitters died of lung cancer, which was slightly lower than that of smokers (16.39%) and significantly higher than that of non-smokers (5.55%). With the increase of smoking degree, the proportion of smokers who died of lung cancer also increased gradually, from 9.19% to 19.11%. Conclusions:From 2010 to 2019, the smoking prevalence of dead residents in Tianjin shows a downward trend, which is consistent with the change trend of the overall smoking prevalence of residents in Tianjin. Lung cancer, acute myocardial infarction and ischemic heart disease rank among the top three causes of death among smokers.