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The future of smoking‐attributable mortality: the case of E ngland & W ales, D enmark and the N etherlands
Author(s) -
Stoeldraijer Lenny,
Bonneux Luc,
Duin Coen,
Wissen Leo,
Janssen Fanny
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12775
Subject(s) - demography , lung cancer , medicine , mortality rate , population , attributable risk , cohort , environmental health , sociology
Aims We formally estimate future smoking‐attributable mortality up to 2050 for the total national populations of E ngland & W ales, D enmark and the N etherlands, providing an update and extension of the descriptive smoking‐epidemic model. Methods We used smoking prevalence and population‐level lung cancer mortality data for E ngland & W ales, D enmark and the N etherlands, covering the period 1950–2009. To estimate the future smoking‐attributable mortality fraction ( SAF ) we: (i) project lung cancer mortality by extrapolating age–period–cohort trends, using the observed convergence of smoking prevalence and similarities in past lung cancer mortality between men and women as input; and (ii) add other causes of death attributable to smoking by applying a simplified version of the indirect P eto– L opez method to the projected lung cancer mortality. Findings The SAF for men in 2009 was 19% (44 872 deaths) in E ngland & W ales, 22% (5861 deaths) in D enmark and 25% (16 385 deaths) in the N etherlands. In our projections, these fractions decline to 6, 12 and 14%, respectively, in 2050. The SAF for women peaked at 14% (38 883 deaths) in 2008 in E ngland & W ales, and is expected to peak in 2028 in D enmark (22%) and in 2033 in the N etherlands (23%). By 2050, a decline to 9, 17 and 19%, respectively, is foreseen. Different indirect estimation methods of the SAF in 2050 yield a range of 1–8% ( E ngland & W ales), 8–13% ( D enmark) and 11–16% (the N etherlands) for men, and 7–16, 12–26 and 13–31% for women. Conclusions From northern E uropean data we project that smoking‐attributable mortality will remain important for the future, especially for women. Whereas substantial differences between countries remain, the age‐specific evolution of smoking‐attributable mortality remains similar across countries and between sexes.