Increase in deaths from smoking-related cancers is expected in China


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Deaths from smoking-related cancers in China are expected to increase by almost 50% over the next two decades, research published online in the journal shows Tobacco control.

Experiences from other countries where peaks in smoking prevalence occurred in the mid-twentieth century have shown that peaks in smoking-related deaths generally occur several decades later.

For example, smoking prevalence in the United States peaked in 1955 among men and in 1965 among women, but the peak of lung cancer deaths came about four decades later – in the 1990s for men and the 2000s for women.

China’s smoking epidemic started three to four decades later than in the United States, so the peak of deaths from lung cancer has not yet come, the researchers warn.

They used data from various sources, including the China Death Surveillance Database and studies of smoking patterns in China, to model the likely course of smoking-related deaths over the next 20 years.

Between 2002 and 2018, the prevalence of smoking in China fell from 57.4% to 50.5% in men and from 2.6% to 2.1% in women. If the smoking prevalence continues to fall at the same rate, the smoking prevalence in 2040 will be 41.3% among men and 2.16% among women.

However, when the aging of the population is taken into account, the researchers estimate that deaths due to smoking-related cancers will increase between 2020 and 2040 by 44% among men (from 337.2 / 100,000 to 485.6 / 100,000) and by almost 53% among women (from 157.3 / 100,000 to 240.4 / 100,000).

Over the course of 20 years, there would be 8.6 million deaths due to smoking-related cancers in China, equivalent to 117.3 million lost life years. Almost half (46%) of the lost life years would be from adults of working age (54.1 million); 94% of these (110.3 million) would be lost in men.

The Healthy China initiative aims to improve the health of the Chinese population, which is the largest in the world. The goal is to reduce the total smoking rate to 20% by 2030.

If this target were reached, the smoking rate among men would fall to just over 26% by 2040, with around 1.4 million excessive deaths averted, the researchers estimate.

“The observed rate of decline in smoking prevalence is far from that required to meet the Healthy China 2030 target,” they write. “Even if this goal were reached, the rising trend in excess deaths would be reversed only slightly.”

The researchers highlight several potential limitations to their study, which are likely to mean that future smoking-related deaths are an underestimation.

And the lack of age-specific previous smoking rates prevented the analysis from fully taking into account the impact of smoking among people who had quit, nor did it take into account smoking-related deaths due to causes other than cancer or those related. for second-hand smoking.

Assumptions about rumor trends across age groups and cancer mortality rates were also based on limited data, with no increase in life expectancy over time included.

But they warn: “Unless widespread efforts are made to support smoking cessation from families, communities and society as a whole, the enormous loss of human life in the working population over the next 20 years will certainly increase the increasing difficulty in supporting China’s aging society and will go beyond the scope that any single existing intervention can prevent. “

Given that around 22% of daily smokers started as children or young people, “complete prevention of smoking cessation among young people is imperative for future generations to avoid the negative consequences of smoking – related diseases,” they add.

Quitting at a younger age reduces the greatest risk of cancer mortality associated with smoking

More information:
Ning Li et al, Smoking-related cancer deaths among men and women in an aging society (China 2020-2040): a population-based modeling study, Tobacco control (2021). DOI: 10.1136 / Tobacco Control-2020-056444

Provided by British Medical Journal

Citation: Increase in deaths from smoking-related cancers expected in China (2021, November 2) retrieved November 2, 2021 from

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