{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:59:03Z","timestamp":1789419543968,"version":"build-2803163510"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The aim was to offer a comprehensive epidemiological assessment of the global prevalence and the smoking-related Multidrug-resistant tuberculosis (MDR-TB) disease burden from 1990 to 2021 and to forecast the trends in smoking burden over three decades.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared the burden of smoking-related MDR-TB and temporal trends by gender, age, socio-demographic index (SDI), region, and country. Forecasting analyses of the changing trend in the burden of smoking-related MDR-TB up to 2050 was conducted based on the ARIMA model and ES models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The global age-standardized rate (ASR) of smoking-related MDR-TB increased from 1990 to 2021, highlighting a significant disease burden. In 2021, the cumulative Disability adjusted life years (DALYs) attributed to MDR-TB tallied up to 239,707 cases, with Lesotho, Uzbekistan, Kyrgyzstan, bearing the brunt. The likelihood of developing MDR-TB rose as individuals advanced in years, manifesting most acutely among men aged 35\u201339 in lower SDI and Low-middle SDI regions. Predictive analysis suggests that by 2050, deaths and DALYs of smoking-related MDR-TB, as well as their corresponding ASR, will continue to decrease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The burden of MDR-TB worldwide, adjusted for age, and related to smoking, has shown a decline from 1990 to 2021. However, regional disparities have been identified, with some areas experiencing an increase in this burden. These regions with a higher burden emphasize the necessity for the implementation of strong tobacco control measures.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1634772","type":"journal-article","created":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T05:27:28Z","timestamp":1758259648000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Global, regional, and national burdens of MDR-TB attributable to smoking from 1990 to 2021 with a prediction from 2022 to 2050"],"prefix":"10.3389","volume":"13","author":[{"given":"Du","family":"Dan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhang","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liu","family":"Ze-Xin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2361","DOI":"10.1021\/acs.accounts.0c00878","article-title":"Strategies to combat multi-drug resistance in tuberculosis","volume":"54","author":"Singh","year":"2021","journal-title":"Acc Chem 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