To describe and analyze the changes in the burden of cardiovascular disease (CVD) attributed to tobacco in China from 1990 to 2021, as well as to provide a basis for scientific prevention and control of CVD.

Weextracted CVD death and disability adjusted life year (DALY) data attributed to tobacco in China from the 2021 Global Burden of Disease Database from 1990 to 2021, analyzed their trends by Joinpoint software, and used Bayesian Age Period Queue Model (BAPC) to predict the changes in CVD disease burden attributed to tobacco in China from 2022 to 2030.

The number of CVD deaths attributed to tobacco in China rose from 54 300 in 1990 to 101 400 in 2021, with the standardized mortality rate decreasing from 75.59 per 100 000 in 1990 to 52.32 per 100 000 in 2021, representing an average annual decrease of 1.24% (95% CI: -1.53%~-0.95%). The DALYs caused by CVD attributed to tobacco in China increased from 15 158 million person-years in 1990 to 23 530 million person-years in 2021, with the standardized DALY rate decreasing from 1 766.25 per 100 000 in 1990 to 1 145.78 per 100 000 in 2021, representing an average annual decrease of 1.42% (95% CI: -1.63%~-1.20%). Prediction models indicated that the CVD disease burden attributed to tobacco in China from 2022 to 2030 will decrease over time, with the standardized mortality rate and standardized DALY rate potentially reaching 45.47 per 100 000 and 967.51 per 100 000, respectively, in 2030.

Although the standardized mortality rate and DALY rate of CVD attributed to tobacco in China have shown a downward trend from 1990 to 2021, the disease burden is still relatively heavy, with significant differences between genders and ages. This suggests that early prevention of CVD in the elderly population, especially in the elderly male population, should be further strengthened to effectively reduce the burden of CVD disease attributed to tobacco in China.