3.29 Morbidity (ill health) attributable to tobacco-caused disease

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3.0 Background

3.1 Tobacco—a leading preventable cause of death and disease

3.2 Cardiovascular diseases

3.3 Lung cancer

3.4 Respiratory diseases

3.5 Other cancers caused by or associated with smoking

3.6 Reproductive health and smoking

3.7 Pregnancy and smoking

3.8 Infant health and smoking

3.9 Increased susceptibility to infection in smokers

3.10 Eye diseases

3.11 Dental diseases

3.12 Gastrointestinal diseases

3.13 Bone density and risk of fractures

3.14 Effects of smoking on the skin

3.15 Smoking and complications in medical treatment

3.16 Smoking and diabetes

3.17 Poorer levels of general health

3.18 Smoking, motor vehicle crashes and other injuries

3.19 Burns and fires caused by tobacco use

3.20 Tobacco poisoning

3.21 Health effects for younger smokers

3.22 Genetic influences on tobacco-caused disease

3.23 Smoking, dementia and cognitive decline

3.24 Lung disease, smoking and occupational exposures

3.25 Air pollution, cigarette smoking and ill health

3.26 Health effects of smoking brands that claim to deliver lower levels of tar, nicotine and carbon monoxide

3.27 Health effects of smoking tobacco in other forms

3.28 Health 'benefits' of smoking?

3.29 Morbidity (ill health) attributable to tobacco-caused disease

3.30 Deaths attributable to tobacco by disease category

3.31 Morbidity and mortality due to tobacco-caused disease and socioeconomic disadvantage

3.32 Health effects of smoking other substances

3.33 Health effects of chewing tobacco, and of other smokeless tobacco products

3.34 Public perceptions of tobacco as a drug, and knowledge and beliefs about the health consequences of smoking

3.35 Health benefits of cessation

3.36 The global tobacco pandemic

Acknowledgments

References

The preceding sections have outlined the range of illnesses directly attributable to or otherwise associated with tobacco use. In turn, the sequelae of these diseases are widely varied. For example, the five-year survival proportion in Australia for lung cancer patients (smokers and non-smokers combined) is 11% for men and 14% for women, figures that have increased only marginally over the past decades,18 despite medical advances. In about half of all cases, a heart attack is fatal, and of those who survive in the first instance, more than 40% will be dead within a year.10 An estimated 1.10 million Australians are disabled over the long term by heart, stroke and vascular diseases.10 Individuals with chronic bronchitis or emphysema may also experience many years of disability and suffering.

3.29.1 Morbidity due to tobacco measured by hospital beddays, 2004–05—the Department of Health and Ageing, 2007

A report commissioned by the Commonwealth Department of Health and Ageing on the costs of tobacco and other drug use has estimated the numbers of hospital bed days attributable to these substances for the financial year 2004–05 (Table 3.2).7

The report concluded that in 2004–05, tobacco was responsible for more than three quarters of a million hospital bed days. Alcohol caused about 20% more hospital bed days than tobacco. Tobacco was responsible for between three and four times the number of hospital bed days caused by illicit drug use.7 In contrast, tobacco causes the vast majority (almost 90%) of all drug-caused deaths—see Table 3.5 below.

3.29.2 Burden of morbidity due to tobacco—Australian Institute of Health and Welfare, 2007

The Burden of Disease and Injury in Australia 20036 produced by the Australian Institute of Health and Welfare reports on a national study that estimates the amount of ill health and death caused by a range of diseases, injuries and risks to health.[8] In Australia in 2003, cancers and cardiovascular disease (CVD) were the leading causes of death and disability, together making up 37% of the total burden. Of the combined burden for these two disease categories, a large proportion was attributable to death. About 80% of the burden from cancer and cardiovascular disease was due to fatality, and 20% could be attributed to ongoing ill health and disability. Lung cancer was the leading cause of cancer death, followed by colorectal and breast cancers. Coronary heart disease, stroke and peripheral vascular diseases were the most common types of CVD in the Australian population. As discussed earlier in this chapter, smoking causes lung cancer and CVD.

After cancer and cardiovascular disease, the next largest causes of disability and death in Australia were mental disorders and neurological disorders, which together accounted for one quarter of the burden of ill health among Australians. However unlike cancer and CVD, mental illness and neurological disorders have a much lower likelihood of causing death, and instead about 80–90% of the burden of these diseases could be measured in ongoing disability.6

The Burden of Disease and Injury in Australia 2003 also examined the risk factors that lead to burden of disease and injury. Of these, tobacco was the single greatest risk factor for the total population, causing 7.8% of the overall burden6 (see Table 3.1 in Section 3.1). Tobacco was the leading cause of disease and injury in males (9.6%), followed by high blood pressure (7.8%) and high body mass (7.7%). In females, high blood pressure and high body mass were the leading causes of disease and injury (each 7.3%), followed by physical inactivity (6.8%), tobacco use and high blood pressure (each 5.8%).6

Of the total burden of disease and injury caused by tobacco use in Australia, it is estimated that 22% of the burden was due to non-fatal outcomes. The disease processes caused by tobacco that contributed most to tobacco-caused morbidity were stroke, chronic obstructive pulmonary disease, and coronary heart disease.6

This report also provided estimates of the burden of disease attributable to smoking by sex and age group (Table 3.3). The peak age group affected by smoking was 45–64 for both men and women, followed by those aged over 65.