Accelerated decline in tobacco use could extend global life expectancy

According to the Global Disease, Injury and Risk Factors (GBD) study, accelerating declines in smoking prevalence globally by reducing smoking prevalence to 5% from current levels will reduce average life expectancy by 2050. This could potentially help prevent millions of premature deaths. ) Tobacco Forecast collaborators published in lancet public health journal.

This analysis suggests that accelerating progress towards smoking cessation could deliver significant health benefits to the population over the next 30 years.

The findings suggest that, based on current trends, global life expectancy is likely to increase from 73.6 years in 2022 to 78.3 years by 2050. However, if smoking rates were to gradually decline from current levels to 5% in 2022, life expectancy would increase by 1 year for men and 0.2 years for women by 2050. . In a scenario where smoking is eliminated after 2023, life expectancy could increase by up to 1.5 years for men and 0.4 years for women in 2050. In either scenario, millions of premature deaths would also be avoided.

Smoking is the leading risk factor for preventable death and poor health globally, accounting for more than one in 10 deaths in 2021. Smoking prevalence has declined significantly over the past 30 years, but the pace of decline has been uneven and is slowing in many countries. Cancer, ischemic heart disease, and chronic obstructive pulmonary disease (COPD) are and will continue to be the leading causes of premature death from smoking. Together, these conditions account for 85% of avoidable years of life lost (YLL), a measure of premature death.

Several countries have set ambitious targets to reduce smoking prevalence to less than 5% in the next few years. However, significant opportunities remain to expand and strengthen proven policies and interventions to achieve these goals.

We must not lose momentum in our efforts to reduce and ultimately eliminate smoking around the world. Our findings highlight that millions of premature deaths could be avoided by quitting smoking. ”

Professor Stein Emil Vollset, Institute for Health Metrics and Evaluation (IHME) Senior Author

The authors developed their estimates using IHME's Future Health Scenarios platform, which uses data from the GBD study. The new analysis provides detailed projections of health burdens for 204 countries, broken down by age and gender, from 2022 to 2050. This is the first study to comprehensively project the health effects of smoking for all countries and all causes. Also about 365 illnesses and injuries. The main measure studied was YLLs, a measure of premature death in which each death is counted as life expectancy at the age of death. For example, if your ideal life expectancy is 91 years and you die at age 50, your YLL would be 41. Because they lost 41 years that they could have lived.

Life expectancy at birth and YLL were assessed based on three future scenarios. In addition to modeling the most likely future scenario based on current trends, the authors estimated the impact of two alternative scenarios. One assumes a country has steadily reduced smoking levels in its population to 5%. The other modeled the future health impact if smoking was eliminated globally in 2023. By taking the difference between the baseline and the 2023 Tobacco Smoking Elimination Scenario, researchers were able to measure the total future health burden that could theoretically be avoided by the intervention.

The platform allows researchers to predict unique populations for each scenario and allows them to account for changing demographics across scenarios.

Between 1990 and 2022, the age-standardized smoking prevalence among males aged 10 years and older decreased from 40.8% to 28.5%. Over the same period, smoking prevalence among women aged 10 and older decreased from 9.94% to 5.96%.

Estimates based on current trends indicate that smoking prevalence will continue to decline, albeit at a slower pace than in the past 30 years. In 2050, an age-adjusted 21.1% of men and 4.18% of women are estimated to smoke, but there are considerable regional differences, from 3.18% in Brazil to 63.2% in Micronesia for men. up to 0.5% for women in Nigeria and 38.5% in Serbia.

However, the findings show that accelerating efforts to eliminate smoking could reduce premature deaths.

A scenario in which countries reduce smoking prevalence to 5% by 2050 would reduce YLL by 876 million compared to the most likely future scenario. The average life expectancy in 2050 will be 77.1 years for men and 80.8 years for women. Life expectancy for men will increase the most in East, Central and Southeast Asia, where it will increase by 1.2 to 1.8 years. For women, life expectancy will increase the most in East Asia, high-income North America, and Oceania, with an additional 0.3 to 0.5 years added.

Estimates show that under a scenario in which smoking is eliminated worldwide in 2023, up to 2.04 billion YLL of smoking could be avoided by 2050, compared to the most likely future scenario, and by 2050 The average life expectancy for men in 2019 is expected to increase further to 77.6 years and 81 years for men. For women, it is several years.

The authors acknowledge that their study has some limitations. Only the direct health effects of reduced smoking have been estimated, meaning that the effects of associated reductions in second-hand smoke exposure have not been analysed, leading to an underestimate of overall health benefits. It means there is a possibility. This analysis did not take into account the potential health effects of e-cigarettes. This estimate also does not take into account the possibility that medical improvements will accelerate in the future, such as improved detection and treatment of lung cancer.