# Trends and burden of tobacco use in Nepal: Insights from the Global Burden of Disease study 1990–2021

## TL;DR

This study examines the trends and health burden of tobacco use in Nepal from 1990 to 2021, showing a decline in tobacco-related deaths but emphasizing the need for stronger control measures.

## Contribution

The study provides updated insights into age- and sex-specific trends in tobacco-related mortality and disability in Nepal using GBD data.

## Key findings

- The age-standardized tobacco use exposure value decreased from 44.1% in 1991 to 28.2% in 2021.
- Tobacco-related deaths per 100,000 population dropped by 46.7% from 1990 to 2021.
- Tobacco remains a major public health issue in Nepal despite declining trends.

## Abstract

Tobacco consumption is a significant public health problem in Nepal, accounting for 39200 deaths each year, accounting for 23.7% of all deaths. While Nepal has taken several policy measures to strengthen tobacco control, the persistent burden of tobacco and the associated health risks highlight the need for continuous monitoring and evaluation. Therefore, this study assessed the trend in age-specific and sex-specific mortality and disability attributable to different forms of tobacco use (smoking, chewing tobacco) in Nepal from 1990 to 2021.

This observational study used publicly available data from Nepal's Global Burden of Disease (GBD) 2021 estimations. The age-standardized and age-specific summary exposure value (SEV), mortality, and disability-adjusted life years (DALYs) were extracted to measure the burden and trend of tobacco use. The data are presented as percentages or rates per 100000 population.

From 1991 to 2021, the age-standardized SEV of tobacco consumption for both sexes at all ages decreased from 44.1% to 28.2%. The age-standardized deaths attributable to tobacco use, including all forms of tobacco products, decreased by (46.7%) from 262.9 (95% UI: 193.5–344.3) per 100000 in 1990 to 140.2 (95% UI: 101.1–181.9) per 100000 in 2021.

Despite declines in SEV, and DALYs from 1990 to 2021, tobacco use remains a major public health concern. Strengthening smoking cessation programs, enforcing stricter tobacco control policies, raising taxes on tobacco products, and expanding public awareness campaigns are essential to reducing its burden.