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Smoking guidelines could prevent 13 million deaths by 2050

Smoking rates in China could be cut by 40%, claims study

Adrian O'Dowd

Wednesday, 19 February 2014

Around 13 million predicted deaths related to smoking in China by 2050 could be prevented if the country adopted guidelines from the World Health Organization (WHO), concludes a study published online today in the BMJ.

An international team of researchers have calculated that complete implementation of the WHO’s Framework Convention on Tobacco Control (FCTC) in China could prevent smoking related deaths and reduce the country’s smoking rates by more than 40%.

A third of the world’s smokers are in China and more than half of men there smoke. Although the country raised the tax on tobacco products in 2009, this did not lead to higher retail prices for consumers. The only ban that has been enforced on smoking there is on public transport.

Researchers from Spain, France and the US used a version of the SimSmoke Tobacco Control Policy model (a computer simulation model of tobacco smoking prevalence and smoking-related deaths) and used data from China to estimate the potential health impact of this programme until 2050.

Data on China’s adult population, current and former smoking prevalence, start and cessation rates, and past policy levels were entered into SimSmoke in order to predict past smoking rates and to project future status quo rates.

Under current policies, a total of more than 50 million deaths due to smoking were estimated from 2012 to 2050.

If the status quo was preserved, the researchers calculated that active smoking in males would fall from 51.3% in 2015 to 46.5% by 2050 – and in females from 2.1% to 1.3% over the same period.

In males, annual deaths were expected to peak at 1.5 million in 2040, but then drop to 1.4 million by 2050. In females, annual deaths from smoking were estimated to be 49,000 in 2040 and 42,000 by 2050.

If cigarette taxes were increased to 75% of the package price, this could reduce smoking prevalence by almost 10% for both males and females by 2015, they calculated.

In this scenario by 2050, smoking prevalence would be reduced by 13% amongst men and 12% amongst women, meaning that between 2015 and 2050, such a tax would save approximately 3.5 million lives.

Smoke-free air laws and a well enforced marketing ban also showed potent and immediate effects, they said.

Comprehensive smoke-free air laws were estimated to show a 9% reduction in smoking rates by 2015, increasing to about a 10% reduction in 2050, potentially averting around 3.4 million deaths.

A comprehensive marketing ban could also cut smoking prevalence by about 4% and avert just over two million deaths by 2050 while a high intensity tobacco control campaign could lead to a 2.5% relative decline in smoking rates by 2015 and prevent 1.1 million deaths due to smoking by 2050.

Overall, the researchers estimated that complete implementation of the WHO framework “would lead to as much as a 34% relative reduction in male smoking prevalence by 2020, and a 41% reduction by 2050.”

They concluded: “Complete implementation of WHO FCTC recommended policies would prevent more than 12.8 million smoking attributable deaths in China by 2050.

“Implementation of FCTC policies would alleviate a substantial portion of the tobacco related health burden that threatens to slow China’s extraordinary gains in life expectancy and prosperity.”

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