Menu

Smoking's Death Toll

Download book chapter
Call To Action

As tobacco use is the most common preventable cause of death, governments must implement effective policies to prevent tobacco use (reducing initiation and promoting cessation) and involuntary exposure to tobacco smoke in order to save lives. Death registries should collect data on tobacco use status to help assess and monitor national tobacco-related death rates.

Percentage of male deaths due to smoking: all ages, 2010

Percentage of female deaths due to smoking: all ages, 2010

Globally, tobacco use killed 100 million people in the 20th century, much more than all deaths in World Wars I and II combined. Tobacco-related deaths will number around 1 billion in the 21st century if current smoking patterns continue. Among middle-aged persons, tobacco use is estimated to be the most important risk factor for premature death in men and the second most important risk factor in women (following high blood pressure) in 2010–2025. To understand better how to address this issue, tobacco deaths need to be monitored closely, and this can be done best if death registries systematically collect data on tobacco use status. Currently, data on tobacco deaths mostly come from individual epidemiological studies.

Tobacco use increases the risk of death from many diseases; cancer, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and stroke are the most common ones. Lung cancer is the leading cause of cancer death worldwide, killing approximately 1.4 million people globally in 2008. At least 80% of lung cancer deaths are attributable to smoking. Even in Northern Africa, where smoking prevalence has increased more recently, lung cancer is the most common cause of cancer death in men. Not only does tobacco use cause disease, but patients with coronary heart disease, cancer, or several other diseases who continue smoking are also at significantly higher risk of death compared to patients with the same disease who never smoked or who quit smoking after being diagnosed with the disease.

Even for those who smoke 10 or fewer cigarettes per day, life expectancy is on average 5 years shorter and lung cancer risk is up to 20 times higher than in never-smokers. Those who smoke fewer than 4 cigarettes per day are at up to 5 times higher risk of lung cancer. As there is neither a safe tobacco product, nor a safe level of tobacco use, the best way to prevent tobacco-related deaths is to avoid using it. Current smokers greatly benefit from quitting smoking (see Quitting).

Sources

Asma S, Song Y, Cohen J, Eriksen M, Pechacek T, Cohen N, et al. CDC Grand Rounds: global tobacco control. MMWR Morbidity and mortality weekly report. 2014;63(13):277-80.

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS medicine. 2006;3(11):e442.

Kontis V, Mathers CD, Rehm J, Stevens GA, Shield KD, Bonita R, et al. Contribution of six risk factors to achieving the 25×25 non-communicable disease mortality reduction target: a modelling study. Lancet. 2014.

Thun MJ, Carter BD, Feskanich D, Freedman ND, Prentice R, Lopez AD, et al. 50-year trends in smoking-related mortality in the United States. The New England journal of medicine. 2013;368(4):351-64.

Zheng W, McLerran DF, Rolland BA, Fu Z, Boffetta P, He J, et al. Burden of total and cause-specific mortality related to tobacco smoking among adults aged >/= 45 years in Asia: a pooled analysis of 21 cohorts. PLoS medicine. 2014;11(4):e1001631.

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA: a cancer journal for clinicians. 2011;61(2):69-90.

Parkin DM, Bray F, Ferlay J, Jemal A. Cancer in Africa 2012. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2014;23(6):953-66.

Critchley JA, Capewell S. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA : the journal of the American Medical Association. 2003;290(1):86-97.

Warren GW, Kasza KA, Reid ME, Cummings KM, Marshall JR. Smoking at diagnosis and survival in cancer patients. International journal of cancer Journal international du cancer. 2013;132(2):401-10.

Li K, Husing A, Kaaks R. Lifestyle risk factors and residual life expectancy at age 40: a German cohort study. BMC medicine. 2014;12(1):59.

Freedman ND, Leitzmann MF, Hollenbeck AR, Schatzkin A, Abnet CC. Cigarette smoking and subsequent risk of lung cancer in men and women: analysis of a prospective cohort study. The lancet oncology. 2008;9(7):649-56.

Disparity in tobacco deaths

Percentage of smoking-related deaths in mixed-race (mixed black and white ancestry, generally with lower socioeconomic status) and white men (ages 35-74 years) in South Africa: 1999–2007

Tobacco-related deaths are more common in people with lower socioeconomic status. In South Africa, mixed race men tend to be of lower socioeconomic status than white men.

25%+

Male deaths 25% and greater: 2010

34% | DPR KOREA
31% | TURKEY
30% | BOSNIA AND HERZEGOVINA
30% | ARMENIA
30% | GREECE
29% | MACEDONIA
28% | BELARUS
28% | RUSSIA
28% | POLAND
27% | UKRAINE
27% | GEORGIA
26% | NETHERLANDS
26% | LATVIA
26% | MONTENEGRO
25% | BELGIUM
25% | HUNGARY

15%+

Female deaths 15% and greater: 2010

22% | DPR KOREA
21% | BRUNEI
20% | DENMARK
19% | ALBANIA
18% | LEBANON
17% | BOSNIA AND HERZEGOVINA
17% | CUBA
16% | UNITED KINGDOM
16% | USA
16% | SERBIA
15% | IRELAND
15% | FYR MACEDONIA
15% | ICELAND

“Estimates from patients at our oral cancer ward indicate that 80–90 percent of preventable cancers of the neck, head, and throat are tobacco-related. More than one million Indians die prematurely from tobacco-related disease each year.” — Pankaj Chaturvedi, cancer specialist at Mumbai’s Tata Memorial Hospital, India

Deaths by country income

Proportion of global smoking-related deaths in low-, middle-, and high-income countries: all ages, 2010

More than two thirds of tobacco deaths occur in low- and middle-income countries.

“Smoking is a cause of real and serious diseases, cancer, particularly cancer of the lung, stroke, heart attack, and respiratory disease such as bronchitis and emphysema. For a lifetime smoker, about half can expect to die prematurely as a result of their cigarette smoking.” — David O’Reilly, Scientific Director, British American Tobacco, 2014

Approximately 80% of all deaths from chronic obstructive pulmonary disease (COPD) are caused by smoking.

Almost 90% of COPD deaths occur in low- and middle-income countries. It has been estimated that COPD will be the third leading cause of death in 2030 worldwide.

Download book chapter
Close