3.30 Deaths attributable to tobacco by disease category

Show / hide chapter menu

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

Three recent studies have estimated the numbers of deaths caused by tobacco use in Australia.6–8 Some of the key findings are presented in this section.

3.30.1 Estimated mortality from tobacco use in Australia in 2004–05—the Department of Health and Ageing, 2007

The most recent estimates of deaths caused by tobacco use show that almost 15,000 people died due to tobacco use in the financial year 2004–05.7 These calculations are the most recent in a series,6, 181, 182 the first of which was published in 1990.183 The methodology used in these reports has calculated 'attributable fractions' for the proportion of deaths due to specific diseases that can be said to have been caused by tobacco, based on extensive literature reviews and developed progressively since the first publication.

By this methodology, it has been estimated that in 2004–05, tobacco use caused a total of 14,901 deaths.7 Of these deaths, 14,790 were attributable to active smoking (including 56 deaths in infants subjected to maternal smoking) and 113 occurred in adults due to exposure to secondhand smoke (Table 3.4).20 As discussed in Section 3.28, smoking also confers a protective effect against a small number of diseases. It is estimated that in 2004–05, smoking prevented death from these specific diseases in 148[9] smokers. However it should be noted that prevention of one kind of disease in a certain individual does not confer immunity against other diseases caused by smoking in the same individual; smokers do still die from these specific diseases; and there is no sound medical basis for taking up or continuing smoking in order to prevent or ameliorate the process of any disease.

The same study also quantified deaths caused by other drug use in Australia. Table 3.5 shows that most drug-caused deaths in tobacco are caused by tobacco. Almost 90% of deaths due to drugs in 2004–05 were caused by smoking compared to 6% from alcohol and 5% from illicit drug use.7

3.30.2 Estimated mortality from tobacco use, 2003—the Australian Institute of Health and Welfare, 2007

The Burden of Disease and Injury in Australia 2003,6 (discussed in Section 3.29.2 above) also quantified deaths due to tobacco use, estimating that smoking caused a total of 15,511 deaths in 2003, or more than one in every 10 deaths (11.7%) (Table 3.6). The methodology used in this study is similar to that used in the AIHW/DoHA studies described in Section 3.30.1.

Lung cancer was the leading cause of deaths due to smoking, followed by chronic obstructive pulmonary disease, coronary heart disease and stroke. This study did not report separately on fatalities due to tobacco by age or gender. The calculations include deaths attributable to secondhand smoke, but separate estimates for the numbers of deaths caused by active smoking and exposure to secondhand smoke are not provided.6

3.30.3 Estimated mortality from tobacco use, 2000—Peto et al methodology

Estimates of deaths caused by smoking in Australia have been calculated by Peto et al for 2000,8 using a methodology first described in 1992.184 Extrapolating from WHO mortality for lung cancer and other diseases, and using UN population data, Peto et al estimate that a total of 19,184 deaths were caused by active tobacco use in Australia in 2000 (Table 3.7).8 The authors state that these estimates are likely to be conservative, because they do not include any deaths in individuals aged under 35 (including infants). Just under one third (about 6,000) of all deaths due to smoking occur in individuals aged between 35 and 69, who lose, on average, about 23 years of life.185

The robustness and wide applicability of this methodology has enabled Peto et al to expand their calculations to worldwide estimates of mortality due to tobacco.186 (See Section 3.36).

Figure 3.2 presents the final column from Peto et al's data shown in the table above. This pie chart shows that of all deaths due to tobacco, 44% are cancer deaths, 23% are due to heart and circulatory diseases, and a further 23% are caused by lung and other respiratory disease.