The future of smoking-attributable mortality: the case of England & Wales, Denmark and The Netherlands

L. Stoeldraijer, L. Bonneux, C. van Duin, L.J.G. van Wissen, F. Janssen

Research output: Contribution to journal/periodicalArticleScientificpeer-review

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Abstract

Aims: We formally estimate future smoking-attributable mortality up to 2050 for the total national populations of England & Wales, Denmark and the Netherlands, providing an update and extension of the descriptive smoking-epidemic model.
Methods: We used smoking prevalence and population-level lung cancer mortality data for England & Wales, Denmark and the Netherlands, 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 Peto–Lopez method to the projected lung cancer mortality.
Findings: The SAF for men in 2009 was 19% (44 872 deaths) in England & Wales, 22% (5861 deaths) in Denmark and 25% (16 385 deaths) in the Netherlands. 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 England & Wales, and is expected to peak in 2028 in Denmark (22%) and in 2033 in the Netherlands (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% (England & Wales), 8–13% (Denmark) and 11–16% (the Netherlands) for men, and 7–16, 12–26 and 13–31% for women.
Conclusions: From northern European 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.
Original languageEnglish
Pages (from-to)336-345
JournalAddiction
Volume110
Issue number2
DOIs
Publication statusPublished - 2015

Keywords

  • smoking-attributable mortality
  • smoking
  • mortality
  • England
  • Wales
  • Denmark
  • Netherlands
  • future
  • SSCI

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