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Smoking: How large of a global problem is it? And how can we make progress against it?

The two regularly updated studies on the global death toll from tobacco use – published respectively by the World Health Organization and the Institut

  • The two regularly updated studies on the global death toll from tobacco use – published respectively by the World Health Organization and the Institute for Health Metrics and Evaluation – agree that around 8 million people die prematurely every year from smoking. More details in our Our World in Data entry on smoking.

  • About 58 million people die every year.

  • The annual death toll from tobacco use estimated in the Global Burden of Disease study is 8.7 million, as cited above. This corresponds to 23,836 deaths on any average day.
    Over the past decade, terrorists killed an average of 21,000 people worldwide each year. See our entry on terrorism: https://ourworldindata.org/terrorism

  • The Global Burden of Disease publishes estimates for countries around the world – we visualized their estimates here. In many high-income countries smoking causes between 15% to 20% of all deaths.
    According to the US CDC smoking causes an even higher share of deaths in the US than what the GBD estimates suggest; the CDC estimates that it leads to the premature death of about 20% of Americans (1,300 deaths every day). See the US CDC on Smoking & Tobacco Use.

  • According to the latest Global Burden of Disease study 8.7 million die prematurely from smoking. The huge majority – 6.2 million corresponding to 71% of the total – are men.

  • Banks et al (2015) find that “Current smokers are estimated to die an average of 10 years earlier than non-smokers.”

    Banks, E., Joshy, G., Weber, M.F. et al. (2015) – Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med 13, 38 (2015). https://doi.org/10.1186/s12916-015-0281-z 

    Pirie et al (2013) estimate a loss of 11 life years.

    Pirie K, Peto R, Reeves GK, Green J, Beral V, Million Women Study Collaborators (2013) – The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013;381:133–41.

    For many additional references that suggest a similar loss of life years see U.S. Department of Health and Human Services (2014) – The Health Consequences of Smoking – 50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

  • Reitsma et al. (2021) – Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019. In The Lancet, 397(10292), 2337–2360.

  • Prabhat Jha and Richard Peto (2014) – Global Effects of Smoking, of Quitting, and of Taxing Tobacco. N Engl J Med 2014; 370:60-68 DOI: 10.1056/NEJMra1308383

  • British epidemiologists Richard Doll and Austin Bradford Hill began suspecting the link in the late 1940s, but it took them a long time to convince first themselves, then other health professionals, and finally the public. The report of the US Surgeon General’s first Smoking and Health in 1964 is seen as the landmark report that made it known to a wide public that smoking cigarettes has dangerous health effects, including lung cancer and heart disease. Some other pioneers – like Pearl in Baltimore – presented evidence even earlier (late 30s), but a consensus was only established much later.

  • Smoking isn’t the only case where the negative impact of a practice wasn’t seen until statisticians made them visible. It also feels obvious to us today that basic hygiene is key to staying healthy, but until the late 19th century even doctors were entirely unaware of the importance of hygiene – it was common practice to deliver babies right after performing autopsies without the doctors washing their hands in between. The widespread lack of hygiene was one of the main causes of maternal mortality and countless children lost their mother right in the moment she gave birth to them.
    See my article on Ignaz Semmelweis and the history of maternal mortality – Roser (2017) Measurement Matters – The decline of maternal mortality on Our World in Data.

  • See U.S. Department of Health and Human Services (2014) – The Health Consequences of Smoking – 50 Years of Progress. A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014.

  • According to CDC – History of the Surgeon General’s Reports on Smoking and Health

  • On the following section and the big question of what is increasing and decreasing smoking see ‘The Economics of Tobacco and Tobacco Control’:

    U.S. National Cancer Institute and World Health Organization (2016) – The Economics of Tobacco and Tobacco Control. National Cancer Institute Tobacco Control. Monograph 21. NIH Publication No. 16-CA-8029A. Bethesda, MD: U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute; and Geneva, CH: World Health Organization; 2016. 

    See also: Frank J. Chaloupka & Michael Grossman (1996) – Price, Tobacco Control Policies and Youth Smoking

  • The latest estimates on the death toll from secondhand smoking from the WHO and the IHME are similar. As of June 2021 the IHME estimates 1.3 million deaths and the WHO estimates 1.2 million deaths.

  • Banks, E., Joshy, G., Weber, M.F. et al. (2015) – Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med 13, 38 (2015). https://doi.org/10.1186/s12916-015-0281-z 

    Reitsma et al. (2021) – Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990–2019: A systematic analysis from the Global Burden of Disease Study 2019. In The Lancet, 397(10292), 2337–2360.

  • The annual death toll from tobacco use estimated in the Global Burden of Disease study is 8.7 million, as cited above. This corresponds to 23,836 deaths on any average day. Some of these deaths are due to other forms of tobacco use, but the large majority are due to smoking.

  • Banks et al (2015) write “Among past smokers, mortality diminished gradually … and did not differ significantly from never-smokers in those quitting prior to age 45.”

    Banks, E., Joshy, G., Weber, M.F. et al. (2015) – Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med 13, 38 (2015). https://doi.org/10.1186/s12916-015-0281-z 

    Pirie et al (2013) find “Smokers who stop at about 40 years of age avoid about 90% of the excess hazard among continuing smokers, whereas those who stop at about 30 years of age avoid about 97% of it. Hence, stopping well before age 40 years would avoid well over 90% of the excess hazard in continuing smokers, and stopping well before age 30 years would avoid well over 97% of it.”

    Pirie K, Peto R, Reeves GK, Green J, Beral V, Million Women Study Collaborators (2013) – The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013;381:133–41.

    But smoking cessation at any age – not just at a young – dramatically reduces death rates. 

    See alsoThun M, Carter B, Feskanich D, Freedman N, Prentice R, Lopez A, et al. (2013) – 50-year trends in smoking-related mortality in the United States. N Eng J Med.2013 Jan 24;368(4):351-64. doi: 10.1056/NEJMsa1211127.

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