Abstract
OBJECTIVE: To estimate smoking-attributable mortality in the long-term future in 29 European countries using a novel data-driven forecasting approach that integrates the wave pattern of the smoking epidemic and the cohort dimension.
METHODS: We estimated and forecasted age-specific and age-standardised smoking-attributable mortality fractions (SAMF) and 95% projection intervals for 29 European countries by sex, 1950-2100, using age-period-cohort modelling with a generalised logit link function. We projected the (decelerating) period increases (women) by a quadratic curve to obtain future declines, and extrapolated the past period decline (men). In addition, we extrapolated the recent cohort trend.
RESULTS: SAMF among men are projected to decline from, on average, 25% in 2014 (11% (Sweden)-41% (Hungary)) to 11% in 2040 (range: 6.3%-15.4%), 7% in 2065 (range: 5.9%-9.4%) and 6% in 2100. SAMF among women in 21 non-Eastern European countries, currently at an average of 16%, are projected to reach peak levels in 2013 (Northern Europe), 2019 (Western Europe), 2027 (Greece, Italy) and 2022 (Central Europe), with maximum levels of, on average, 17% (8% (Greece)-28% (Denmark)), and to decline to 10% in 2040 (range: 4%-20%), 5% in 2065 (range: 3.5%-7.6%) and 4% in 2100. For women, a short-term shift in the peak of the inverse U-shaped age pattern to higher ages is projected, and crossovers between the age-specific trends.
CONCLUSION: Our novel forecasting method enabled realistic estimates of the mortality imprint of the smoking epidemic in Europe up to 2100. The high peak values in smoking-attributable mortality projected for women warrant attention.
Original language | English |
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Article number | 055658 |
Pages (from-to) | 523-529 |
Number of pages | 7 |
Journal | Tobacco Control |
Volume | 30 |
Issue number | 5 |
Early online date | 7-Aug-2020 |
DOIs | |
Publication status | Published - Sept-2021 |
Keywords
- end game
- smoking caused disease
- surveillance and monitoring