Smoking epidemic in Europe in the 21st century

Fanny Janssen, Shady El Gewily, Anastasios Bardoutsos

OnderzoeksoutputAcademicpeer review

5 Citaten (Scopus)
3 Downloads (Pure)


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.

Originele taal-2English
Pagina's (van-tot)523-529
Aantal pagina's7
TijdschriftTobacco Control
Nummer van het tijdschrift5
Vroegere onlinedatum7-aug-2020
StatusPublished - sep-2021

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