3.30 Total burden of death and disease attributable to tobacco by disease category

 

Last updated:November 2021

Suggested citation: Greenhalgh, EM & Winnall, W. 3.30 Total burden of death and disease attributable to tobacco by disease category. In Greenhalgh, EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2021. Available from https://www.tobaccoinaustralia.org.au/chapter-3-health-effects/3-30-total-burden-of-death-and-disease-attributable-to-tobacco-by-disease-category

 

Worldwide, smoking is a leading preventable cause of morbidity and mortality, and in Australia is consistently the number one modifiable risk factor contributing to disease burden and deaths.1 In Australia, up to two-thirds of deaths in current smokers can be attributed to smoking, who lose on average a decade of life.2 Several studies have estimated the numbers of deaths caused by tobacco use in Australia;1,3,4 Some of the key findings are presented in this section.

3.30.1 Estimated mortality and morbidity from tobacco use, 2018—the Australian Institute of Health and Welfare (2021)

The Australian Burden of Disease study estimated that tobacco use caused a total of almost 20,500 deaths in 2018, or more than one in every eight deaths (13%).1 In 2018, 8.6% of the disease burden in Australia was due to tobacco use, making it the leading risk factor that contributed to disease burden and deaths. This equated to 430,903 years of healthy life lost (‘disability-adjusted life years’, or DALYs) from death and illness due to tobacco use in Australia in 2018.1

Tobacco use was causally linked to the burden of 41 individual diseases including: 19 types of cancer; seven cardiovascular diseases; chronic obstructive pulmonary disease (COPD); and asthma. About three quarters of all DALYs from COPD, lung cancer, and laryngeal cancer were due to tobacco use. Table 3.30.1 shows the DALYs due to tobacco use in Australia in 2018, as well as the proportion of DALYs for each disease attributable to tobacco use.

Table 3.30.1 DALYs attributable to tobacco use by specific cause, Australia, 2018

Source: AIHW Australian Burden of Disease Study, supplementary tables5  

Chronic obstructive pulmonary disease was the leading cause of death and illness due to smoking, followed by lung cancer, coronary heart disease and stroke (Table 3.30.1).

Figure 3.30.1 shows all deaths attributable to smoking in Australia by disease entity, as a proportion of all tobacco-caused deaths in 2018. Lung cancer (35%) and respiratory diseases (28%) were the most common causes of deaths attributed to smoking in 2018.

 

Figure 3.30.1 Deaths attributable to smoking in Australia by disease entity, as a proportion of all tobacco-caused deaths, 2018

Source: AIHW Australian Burden of Disease Study, supplementary tables5   

3.30.2 Estimated mortality and morbidity from tobacco use, 2019—the Global Burden of Disease Study

The Global Burden of Disease study estimates levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks factors.6 Globally, an estimated 8.71 million deaths and 230 million DALYs were attributable to tobacco in 2019. 7 It estimated from past Global Burden of Disease data that in Australia, in 2019, 541,539 DALYs were attributable to tobacco. Disease groups with the greatest DALY burden attributable to tobacco in Australia in 2019 included chronic respiratory diseases (33%); cancer (19%); and cardiovascular diseases (14%).8  

 

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References

1. Australian Institute of Health and Welfare. Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2018. Canberra: AIHW, Australian Government 2021. Available from: https://www.aihw.gov.au/reports/burden-of-disease/abds-impact-and-causes-of-illness-and-death-in-aus/summary.

2. Banks E, Joshy G, Weber MF, Liu B, Grenfell R, et al. Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Medicine, 2015; 13(1):38. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25857449

3. Collins D and Lapsley H. The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/05., Canberra: Department of Health and Ageing, 2008. Available from: https://nadk.flinders.edu.au/files/3013/8551/1279/Collins__Lapsley_Report.pdf.

4. Peto R, Lopez AD, Pan H, Boreham J, and Thun M. Mortality from smoking in developed countries 1950 - 2020. 2015. Available from: http://gas.ctsu.ox.ac.uk/tobacco/contents.htm

5. Australian Institute for Health and Welfare. Australian Burden of Disease Study: Impact and causes of illness and death in Australia, 2018 Supplementary tables. AIHW, Australian Government,  2021. Available from: https://www.aihw.gov.au/reports/burden-of-disease/abds-2018-interactive-data-risk-factors/data.

6. G.B.D. Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet, 2020; 396(10258):1223-49. Available from: https://www.ncbi.nlm.nih.gov/pubmed/33069327

7. G.B.D. 2019 Tobacco Collaborators. Global health metrics: Tobacco—level 2 risk. Lancet, 2020. Available from: https://www.thelancet.com/pb-assets/Lancet/gbd/summaries/risks/tobacco-smoke.pdf

8. Global Health Data Exchange. Global Burden of Disease results. Institute for Health Metrics and Evaluation, University of Washington 2019. Available from: http://ghdx.healthdata.org/gbd-results-tool.