Cigarettes: a product that kills two out of three of its users

NIH

Smoking Kills is more than just a catchy PSA or smoking cessation campaign slogan it s verifiable fact. Since the mid 1900s, study after study has generated compelling evidence linking smoking to increased mortality rates. Arguably, the most influential of these is the 1956 publication of smoking data on the British Doctors Study, which presented compelling evidence that over half of smokers would eventually die due to smoking related complications. A new study published in BMC Medicine asserts that this mortality rate may even be as high as 66 percent, meaning that two out of three smokers will eventually die from conditions associated with their smoking.

This study, put together by investigators from the National Centre for Epidemiology and Population Health at the Australian National University, followed 204,953 men and women over 45 years old from New South Wales, Australia. These participants were categorized into groups of smokers, past smokers, and never smokers.

The investigators found the percentage of smokers was comparable among men and women. They also found that current smokers were likely to be younger than never smokers, and they were less likely to live in urban areas. Current smokers had lower income and education when compared to never smokers, and they were less likely to hold private health insurance. Finally, current smokers were more likely to report consuming over 15 alcoholic drinks a week and were more likely to have a higher body mass index.

(These factors were accounted for when the mortality statistics were examined.)

Person years are a measure of time used in epidemiological studies, in which the years studied for all participants in a study are added together. For example, if three people were studied for 10 years each, 30 total person years would be reported in the study. In the study published in BMC Medicine, a total of 874,120 person years were examined, and during those person years, 5,593 deaths occurred among the study population.

Epidemiological outcomes are typically reported in terms of Relative Risk , which describes the proportion of the risk of an outcome that can be attributed to a specific factor. In this study, the relative risk of death (known as mortality) for male and female smokers showed that they were approximately 2.76 and 2.95 times more likely to die than never smokers. Quitting helps male and female past smokers were 1.27 and 1.39 times more likely to die than never smokers. These numbers, while not surprising given the large body of data on the risks of smoking, are nonetheless a staggering reminder of the quantifiable risks of smoking.

The investigators also examined the mortality rate in relation to the number of cigarettes smoked per day. They found that there was a two fold increase in mortality for participants who smoked 1 14 cigarettes per day and a four fold increase in mortality for those who smoked more than 25 cigarettes per day (compared to never smokers).

This study does report the promising finding that quitting smoking, even later in life, can considerably reduce the risk of mortality associated with smoking, a finding that s been demonstrated several times in the literature on smoking. The researchers found that when they compared participants who had quit smoking at ages 45 54, the relative risk of dying for men and women was only 1.36 or 1.52 times the risk of dying in never smokers. They found that the risk of death declined progressively, and this was proportional to the amount of time that passed since the participant quit smoking.

Though the findings of this study are extremely similar to smoking studies conducted in the US and the UK, this is the first large scale population study conducted in Australia, and demonstrating that the risks of smoking transcend cultural lifestyle factors. Additionally, despite the fact that this finding is similar to the existing literature on the risks of smoking, this striking data on the nearly three fold increase in mortality for smokers remains relevant, as many people seem to either ignore or never fully register that message.

The good news is that it s not too late to quit smoking to improve your future health.

BMC Medicine, 2015. DOI 10.1186/s12916 015 0281 z (About DOIs).

List of countries by cigarette consumption per capita – wikipedia, the free encyclopedia

This is a list of countries by annual per capita consumption of tobacco cigarettes.

Cigarettes are smoked by over 1.1 billion people. While smoking rates have leveled off or declined in developed nations, in developing nations tobacco consumption continues to rise at a rate of around 3.4% per annum. citation needed

Smoking rates in the United States have dropped by half from 1965 to 2006 falling from 42% to 20.8% of adults, 1 with further significant decline to 18 percent by 2012. 2 There are large regional differences in smoking rates, with Kentucky, West Virginia, Oklahoma and Mississippi topping the list, and Idaho, California and Utah at significantly lower rates. 3

In Australia the incidence of smoking is in decline, with figures from 2011 13 showing 16.1% of the population (over 18) to be daily smokers, a decline from 22.4% in 2001. Young adults are the most likely age group to smoke, with a marked decline in smoking rates with increasing age. The prevalence of smoking is strongly associated with socioeconomic disadvantage low earners , with over double the rate in the most disadvantaged quintile of the population as compared to the least. 4

List edit Ranking Country Number of cigarettes
per adult per year 1 Serbia 2,924 2 Bulgaria 2,822 3 Greece 2,795 4 Russia 2,786 5 Moldova 2,479 6 Ukraine 2,401 7 Slovenia 2,360 8 Bosnia and Herzegovina 2,278 9 Belarus 2,266 10 Montenegro 2,157 11 Lebanon 2,139 12 Czech Republic 2,125 13 South Korea 1,958 14 Republic of Macedonia 1,934 15 Kazakhstan 1,934 16 Azerbaijan 1,877 17 Japan 1,841 18 Kuwait 1,812 19 Spain 1,757 20 Switzerland 1,722 21 China 1,711 22 Austria 1,650 23 Tunisia 1,628 24 Croatia 1,621 25 Armenia 1,620 26 Cyprus 1,620 27 Poland 1,586 28 Estonia 1,523 29 Hungary 1,518 30 Italy 1,475 31 Belgium 1,455 32 Denmark 1,413 33 Romania 1,404 34 Slovakia 1,403 35 Turkey 1,399 36 Malta 1,378 37 Jordan 1,372 38 Cuba 1,261 39 Albania 1,116 40 Portugal 1,114 41 Trinidad and Tobago 1,106 42 Egypt 1,104 43 Indonesia 1,085 44 Tajikistan 1,046 45 Germany 1,045 46 Argentina 1,042 47 Georgia 1,039 48 Monaco 1,038 49 Israel 1,037 50 Australia 1,034 51 United States 1,028 52 Syria 1,013 53 Ireland 1,006 54 Vietnam 1,001 55 Kyrgyzstan 942 56 Luxembourg 928 57 Iraq 864 58 Chile 860 59 France 854 60 Oman 852 61 Philippines 838 62 Libya 818 63 Canada 809 64 Saudi Arabia 809 65 Lithuania 804 66 Netherlands 801 67 Mauritius 787 68 Latvia 785 69 Andorra 784 70 Algeria 775 71 Uruguay 770 72 Brunei 751 73 United Kingdom 750 74 Sweden 715 75 Finland 671 76 Papua New Guinea 670 77 Bahrain 661 78 Iran 657 79 North Korea 650 80 Nauru 626 81 Paraguay 619 82 United Arab Emirates 583 83 Comoros 583 84 New Zealand 579 85 Seychelles 565 86 Thailand 560 87 Mongolia 555 88 Singapore 547 89 Malaysia 539 90 Namibia 534 91 Norway 534 92 Fiji 530 93 Costa Rica 529 94 Brazil 504 95 Gabon 501 96 Morocco 500 97 Venezuela 496 98 Iceland 477 99 Pakistan 468 100 South Africa 459 101 Cambodia 452 102 Uzbekistan 449 103 Laos 435 104 Nepal 420 105 Angola 414 106 Colombia 412 107 Yemen 402 108 Senegal 398 109 Equatorial Guinea 391 110 Nicaragua 377 111 Antigua and Barbuda 375 112 Mexico 371 113 Belize 367 114 Saint Vincent and the Grenadines 351 115 Barbados 344 116 Cape Verde 339 117 Dominica 339 118 Botswana 336 119 Djibouti 309 120 Togo 307 121 Swaziland 303 122 The Bahamas 288 123 Saint Kitts and Nevis 287 124 Jamaica 283 125 Qatar 281 126 Madagascar 260 127 Saint Lucia 249 128 Guatemala 235 129 Dominican Republic 234 130 Grenada 229 131 Ecuador 227 132 Honduras 217 133 El Salvador 209 134 Mozambique 200 135 Panama 197 136 Sri Lanka 195 137 Myanmar 189 138 Zimbabwe 189 139 Bolivia 179 140 Sierra Leone 177 141 Maldives 170 142 Bangladesh 154 143 Ivory Coast 148 144 Kenya 144 145 Burundi 137 146 Peru 137 147 Turkmenistan 135 148 Tanzania 132 149 Mali 127 150 Bhutan 120 151 Nigeria 116 152 Liberia 113 153 Burkina Faso 109 154 Democratic Republic of the Congo 105 155 Central African Republic 102 156 Haiti 100 157 Guinea Bissau 97 158 India 96 159 Rwanda 94 160 Cameroon 93 161 Chad 86 162 Mauritania 86 163 Gambia 85 164 Sudan 75 165 Eritrea 74 166 Zambia 74 167 Benin 71 168 S o Tom and Pr ncipe 69 169 Somalia 67 170 Lesotho 62 171 Afghanistan 61 172 Suriname 57 173 Niger 52 174 Guyana 49 175 Malawi 48 176 Tonga 48 177 Ghana 44 178 Vanuatu 43 179 Ethiopia 42 180 Samoa 34 181 Tuvalu 29 182 Uganda 24 183 Kiribati 22 184 Solomon Islands 18 185 Guinea 9 References edit

  • ERC. (2007). World Cigarettes 1 The 2007 Report. ERC Statistics Intl PIc. Population data is from Central Intelligence Agency. (2007). The World Factbook 2007. Washington Government Printing Office.