HEALTH AT A GLANCE: EUROPE 2010 OECD 201068
2.6. TOBACCO CONSUMPTION AMONG ADULTS
Tobacco is directly responsible for about one in tenadult deaths
worldwide, equating to about 6 milliondeaths each year (Shafey et
al., 2009). It is a major riskfactor for at least two of the
leading causes of prematuremortality circulatory diseases and a
range of cancers.In addition, it is an important contributory
factor forrespiratory diseases, while smoking among pregnantwomen
can lead to low birth weight and illnessesamong infants. It remains
the largest avoidable risk tohealth in EU countries.
The proportion of daily smokers among the adultpopulation varies
greatly across countries, evenbetween neighboring countries (Figure
2.6.1). In 2008,rates were lowest in Sweden, Iceland, Slovenia
andPortugal, all at less than 20% of the adult populationsmoking
daily. On average, smoking rates havedecreased by about 5
percentage points in EU coun-tries since 1995, with a bigger
decline in men than inwomen. Large declines occurred in Turkey (47%
to27%), Luxembourg (33% to 20%), Norway (33% to 21%)and Denmark
(36% to 23%). Greece maintains thehighest level of smoking (40%),
along with Bulgariaand Ireland, with close to 30% or more of the
adultpopulation smoking daily.
In the post-war period, most EU countries tendedto follow a
general pattern very high smoking ratesamong men (50% or more)
through to the 1960sand 1970s, while the 1980s and the 1990s were
charac-terised by a marked downturn in tobacco consumption.Much of
this decline can be attributed to policies aimedat reducing tobacco
consumption through publicawareness campaigns, advertising bans and
increasedtaxation (World Bank, 1999). In addition to
governmentpolicies, actions by anti-smoking interest groups
werevery effective in reducing smoking rates by changingbeliefs
about the health effects of smoking.
Although large disparities remain, this pattern ofa decline in
smoking rates is found across mostEU countries (Figure 2.6.2).
Smoking prevalence amongmen continues to be higher than among women
in allEU countries except Sweden. Female smoking ratescontinue to
decline in most countries, and in a numberof cases (Turkey,
Iceland, Belgium, Latvia and Ireland)
at an even faster pace than male rates. However, inseven
countries, female smoking rates have beenincreasing since the
mid-1990s (Lithuania, Portugal,Greece, Bulgaria, France, Germany
and Austria), buteven in these countries women are still less
likely tosmoke than men. In 2008, the gender gap in smokingrates
was particularly large in Baltic countries (Latvia,Lithuania and
Estonia), as well as in Turkey andRomania (Figure 2.6.1).
Several studies provide strong evidence of socio-economic
differences in smoking and mortality(Mackenbach et al., 2008).
People in lower social groupshave a greater prevalence and
intensity of smoking,a higher all-cause mortality rate and lower
rates ofcancer survival (Woods et al., 2006). The influence
ofsmoking as a determinant of overall health inequa-lities is such
that, in a non-smoking population,mortality differences between
social groups would behalved (Jha et al., 2006).
Figure 2.6.3 shows the correlation between tobaccoconsumption
(as measured by grams per capita) andincidence of lung cancer
across EU countries for whichdata are available, with a time lag of
two decades. Highertobacco consumption at the national level is
also gener-ally associated with higher mortality rates from
lungcancer one or two decades later across EU countries.
Definition and deviations
The proportion of daily smokers is defined asthe percentage of
the population aged 15 yearsand over reporting smoking every
day.
International comparability is limited due tothe lack of
standardisation in the measurementof smoking habits in health
interview surveysacross EU countries. Variations remain in theage
groups surveyed, wording of questions,response categories and
survey methodologies,e.g. in a number of countries, respondents
areasked if they smoke regularly, rather than daily.
2.6. TOBACCO CONSUMPTION AMONG ADULTS
HEALTH AT A GLANCE: EUROPE 2010 OECD 2010 69
2.6.1. Daily smoking rates, 2008 (or nearest year available)
Source: OECD Health Data 2010; Eurostat Statistics Database.1 2
http://dx.doi.org/10.1787/888932336502
50 40 5030 20 403010 20100 0
1220
2229
2423
3224
2326
2122
2924
2728
3030
3626
3139
3432
4344
4632
3140
46
31
14.517.8
18.919.6
20.020.020.220.420.420.4
21.022.0
22.423.023.223.2
24.224.3
24.725.0
25.926.226.226.326.426.5
27.427.928.0
29.029.1
39.7
171516
1116
189
1818
162221
1622
191919
1423
2122
1719
2215
1213
2527
1934
19
Males Females
% of population aged 15 years and over % of population aged 15
years and over
All adultsSwedenIcelandSloveniaPortugalBelgium
LuxembourgRomaniaFinland
SwitzerlandMalta
NorwayUnited Kingdom
ItalyDenmarkAustria
GermanyEU
Czech RepublicCyprus
Slovak RepublicHungaryFranceEstoniaPolandSpain
LithuaniaTurkeyLatvia
NetherlandsIreland
BulgariaGreece
2.6.2. Change in smoking rates by gender, 1995-2008 (or nearest
year available)
Source: OECD Health Data 2010; Eurostat Statistics Database;
WHOGlobal Infobase.
1 2 http://dx.doi.org/10.1787/888932336521
2.6.3. Tobacco consumption, 1990 and incidence of lung cancer,
2008
Source: OECD Health Data 2010.
1 2 http://dx.doi.org/10.1787/888932336540
-75 -50 -25 0 25 50
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-10-6-6-4-4
7
51
1
-35-24
-27-37-36
-43-44
-9-30
-26-24
-29
-22-19
-27-18
-23-16
-10
-9-11
-15
-12
Males Females
% change over period
TurkeyIceland
BelgiumDenmark
NorwayLuxembourg
SwedenLatvia
SwitzerlandEstonia
United KingdomHungary
NetherlandsEU
SpainFinlandPoland
ItalyCzech Republic
IrelandAustria
GermanyFrance
BulgariaGreece
PortugalLithuania
50
40
30
20
103 0002 5002 0001 5001 000 3 500
R2 = 0.22
AUT
BEL
CZE
DNK
FIN
FRA
DEUGRC
HUN
ISL
IRL
NLD
NOR
SWE
CHE
TUR
GBR
Lung cancer (incidence per 100 000 population)
Tobacco consumption (grams per capita)
