Background Tobacco exposure is the major contributor of CVD mortality, but none of the published studies on CVD mortality attributable to tobacco exposure analyzed the possible reasons underlying the long-term trends and the differences between age-groups in China.Methods The mortality data in China, Japan, USA and World were obtained from GBD 2017. The joinpoint regression analysis was used to assess the magnitude and direction of trends over time for CVD morality, and the age-period-cohort method was used to analyze the temporal trends of CVD mortality by age, period, and cohort. The smoking prevalence was acquired from WHO.Results There was a significant downward trend in ASMR of CVD attributable to smoking in four regions, but China has the smallest decline and the ASMR of CVD attributable to smoking in China rose to the first place in 2017 (41.41 per 100,000). All the net drifts per year in four regions were negative, and the local drift values were below zero in all age groups. The longitudinal age curves of the CVD mortality attributable to smoking increased in four regions and China had the largest increase. The period/cohort RRs indicated a decline, and China has the smallest decline. All the cohort/period RRs and net drifts per year in female had more quickly declining trends than that in male. All the results of secondhand smoke were similar to that of smoking. For Stroke and IHD, their results were similar to those of CVD.Conclusions Although CVD mortality attributable to tobacco exposure had declined in four regions, CVD mortality attributable to tobacco exposure in China was at a high level, and the high CVD mortality attributable to secondhand smoke caused by high smoking prevalence. China should strengthen tobacco control measures to reduce the burden of CVD.

Objective Air pollution is the major contributor of lung cancer mortality, we want to analyze the long-term trends and the differences in lung cancer burden attributable to PM2.5 exposure between ambient air pollution and household air pollution.Methods The indicators (mortality rate, disability-adjusted life years rate, years lived with disability rate, and years of life lost rate) of lung cancer burden were obtained from GBD 2017. The joinpoint regression analysis was used to assess the magnitude and direction of trends from 1990 to 2017, and the age-period-cohort method was used to analyze the temporal trends of the indicators of lung cancer by age, period, and cohort.Results The age-standardized indicators showed an upward trend in ambient PM2.5 exposure (APE) and a downward trend in household PM2.5 exposure (HPE). The overall net drifts per year were above zero for APE and below zero for HPE, and the local drift values in APE and HPE increased by age groups. For the longitudinal age curves, the indicators of lung cancer burden for younger in APE or HPE were in a low level, and significantly increased from 45-49 age group to 90-94 age group. For the period RRs, the indicators of lung cancer burden in APE increased from 1990 to 2017, but decreased in HPE from 1990 to 2017. For the cohort RRs, the indicators of lung cancer burden in APE was on the upward trend before 1965, and fluctuated after from 1970 to 1990. The indicators of lung cancer burden in HPE was on the downward trend.Conclusions For lung cancer attributable to air pollution, China had changed from household air pollution to ambient air pollution. PM2.5 exposure had more harmful in male and older people. Ambient air pollution should be emphasized, China should strengthen implementation of effective public policies and other interventions.