Source: Tobacco Free Initiative
Tobacco’s negative effects on health are many and well-described, including increased risks of heart disease and many cancers. For individual smokers and their families, these risks are some of the most important information in making the decision to quit smoking.
For societies and those who must plan for the future health needs of populations, tobacco’s harmful effects can be understood by looking at the burden of disease associated with tobacco use. Burden of disease calculations are based on models of rates of tobacco use and tobacco’s role in causing a wide range of adverse health effects. These results can be useful in setting priorities for further research, identifying service needs, and, given the substantial burden of disease attributed to tobacco, building support for the comprehensive policies and programs needed to control tobacco.
As tobacco use declines in many developed countries and is increasing rapidly in many developing countries, tobacco’s contribution to the burden of disease will change dramatically between now and 2020. Looking ahead to 2020, the picture changes dramatically – tobacco will become the largest single health problem, causing an estimated 8.4 million deaths annually. This increase will not, however, be shared equally as deaths in developed regions are expected to rise 50% from 1.6 to 2.4 million while those in Asia, (India, China, & Other Asia and Islands), will soar almost fourfold from 1.1 million in 1990 to an estimated 4.2 million in 2020. (Murray CJL, Lopez AD. Lancet Volume 349 Issue 9064:1498-1504)
Making projections about the future can be tricky but some of the strongest data come from China. China is particularly significant for understanding the impact of tobacco as its population is fairly young and roughly two-thirds of adult males are smokers. Two different studies, one retrospective based on investigations of one million deaths during the mid-1980s and the other prospective, set up in 1991 to follow middle aged smokers for the next few decades, concur in their estimates that 12% of deaths are currently attributable to tobacco. In this regard, China appears similar to the world’s developed regions where 14.5% of deaths are attributable to tobacco.
What is dramatically different in China is that the number of smokers is growing rapidly such that two-thirds of men are smokers before age 25, few quit, and about half of these smokers can be expected to be killed by tobacco. Chinese women are much better off – relatively few of them smoke and smoking seems to be on the decline even as it is increasing among men.
In practical terms, this means that the number of male deaths alone from tobacco is expected to be roughly three million annually by the mid-2000s. Put another way, about 100 million of the 300 million Chinese males who are currently younger than 29 will be killed by tobacco, half while middle-aged, thus meaning substantial losses of productive life years, and the other half in later life.