Health Talk | Why eliminating tobacco smoking should be on the agenda of governments

A new analysis on tobacco use provides in-depth forecasts of the health burden for 204 countries, categorised by age and sex, from 2022 until 2050.

Accelerating the decline in tobacco smoking globally, by decreasing smoking prevalence from current levels to 5% everywhere, could increase life expectancy and prevent millions of premature deaths by 2050, according to a study from the Global Burden of Disease, Injuries and Risk Factors (GBD) Tobacco Forecasting Collaborators published this week in The Lancet Public Health journal.

Smoking, as has been established, is a leading risk factor for preventable death and ill health globally(Pixabay)

The authors reiterate what experts world over have said for long that speeding up progress towards ending smoking could deliver substantial health benefits to the population. The authors focussed on a scenario for the next three decades.

Based on current trends, the authors find global life expectancy will likely rise to 78.3 years by 2050 – up from 73.6 years in 2022. However, if tobacco smoking were to gradually decline from current levels to a rate of 5% in 2050, this would result in one year of additional life expectancy in males and 0.2 years in females. In a scenario where tobacco smoking was eliminated from 2023 onwards, this could result in up to 1.5 additional years of life expectancy among males and 0.4 years among females in 2050. In both scenarios, millions of premature deaths would also be avoided.

Smoking, as has been established, is a leading risk factor for preventable death and ill health globally. While rates of smoking have fallen substantially over the past three decades, the pace of decline varies and has slowed in many countries.

Cancers, ischemic heart disease, and chronic obstructive pulmonary disease (COPD) are—and will continue to be—the leading causes of premature deaths from smoking, said the paper. Together, these conditions account for 85% of potentially avoidable years of life lost (YLLs)—a measure of premature deaths.

Several countries have set ambitious goals to reduce smoking rates to below 5% in the coming years. However, there is still significant opportunity to expand and strengthen proven policies and interventions to achieve these targets, they pointed out.

“We must not lose momentum in efforts to reduce, and ultimately eliminate, smoking around the world. Our findings highlight that millions of premature deaths could be avoided by bringing an end to smoking,” said senior author, Stein Emil Vollset, from the Institute for Health Metrics and Evaluation (IHME).

The new analysis provides in-depth forecasts of the health burden for 204 countries, categorised by age and sex, from 2022 until 2050. It is the first study to comprehensively forecast the health impacts due to smoking for all countries and all causes, as well as on 365 diseases and injuries. The main measure studied was YLLs or Years of Life Lost, a measure of premature deaths, counting each death by the remaining life expectancy at the age of death.

In the scenario in which countries reduce smoking rates to 5% by 2050, there would be 876 million fewer YLLs compared to the most likely future scenario. Life expectancy in 2050 would be 77.1 years in males and 80.8 years in females. The greatest gains in life expectancy among males would be in East Asia, Central Asia, and Southeast Asia, with between 1.2 and 1.8 extra years of life gained. Among females, life expectancy would increase the most in East Asia, High-income North America and Oceania, with between 0.3 and 0.5 additional years gained.

For the scenario in which smoking would have ended globally in 2023, the estimates indicate a maximum of 2.04 billion YLLs could be avoided by 2050 compared to the most likely future scenario, and life expectancy in 2050 would be higher still, at 77.6 years for males and 81 years for females.

Bottomline: use of tobacco kills and countries must throw in all the resources they have to ensure there is a decline in the prevalence of users.