Chapter nine

Facts in figures

he following collection of figures is drawn from a range of WHO sources to give an overview of smoking trends in Europe.

There is much variation in smoking prevalence among European countries, as fig.1 shows. In general men smoke more heavily than women but there are large differences between parts of Europe. In the northern and western parts the gender difference tends to be small. In the eastern areas of Europe, particularly in the newly independent countries, the gender difference is generally wide as women have not taken up smoking extensively. One of the main challenges is to prevent the spread of the smoking epidemic among women throughout Europe.

As with adults, there are considerable differences in the smoking prevalence among adolescents between the European countries (figure 2). In general, girls smoke less frequently than boys but there are several countries where the situation is opposite. The rank order of the countries according to smoking prevalence among adolescents differs clearly from that among adults. For example, Finland has high adolescent smoking prevalence but is among the lowest countries in the ranking of adult smoking. The order of countries according to youth smoking prevalence has remained virtually unchanged during the last ten years. The explanation for the discrepancy between adolescent and adult smoking figures is explained by different starting ages. For example, the Finnish adolescents have their first smoking trials much earlier than youth in general in Europe.

The importance of smoking as a cause of death in Europe is seen in fig.3. The tables include age-adjusted total mortality, vascular and cancer mortality. These are shown separately for men and women, and in two age groups (35-69 years and 70 years and older). In addition, the figure shows the number and proportion of smoking-attributed deaths for the diseases mentioned. Figures for the years 1985 and 1990 come from official WHO statistics. The 1995 figures are estimates based on the assumption that smoking prevalence would develop in the same direction and the same speed as in the 1980s. This has, of course, not been the case in many of the countries. In some the development has been more favourable than expected, in others much less so. Thus, the 1995 estimates should be approached with caution, though they do reflect the magnitude of the tobacco problem in different European countries. n

Dr Heikki J. Korhonen

Acknowledgements: Dr Peter Anderson, Dr Tiina Haapaniemi, Professor Lasse J. Kannas

Figure 1. Prevalence of smoking in adults in countries of the WHO European region, early to mid-1990«s (%)

Figure 2. Weekly and daily smoking rates among boys and girls aged 15 in different countries.

Source: Health Behaviour in School-Aged Children. A WHO Cross-National Survey (HBSC-study)

Source: WHO tobacco or health database 1996. Figures for Bosnia and Herzegovina are from a survey of health professionals. Figures for the Russian Federation are estimates by the Ministry of Health and Medical Industry.

Figure 3. Age-adjusted mortality, smoking-attributed deaths and their proportion of cancer, cardiovascular disease (=CVD) and all causes in European countries in 1985, 1990 and projection for 1995.
Source: Peto R, Lopez AD, Boreham J, Thun M, Heath C Jr: Mortality from Smoking in Developed Countries 1950-2000. Oxford University Press 1994.

Armenia

Men 35-69 years 70 years

Year Cancer CVD All All

MORT Sm% SAD MORT Sm% SAD MORT Sm% SAD Sm% SAD

1985 338 47 491 568 33 527 1285 36 1425 12 445

1990 382 52 784 689 36 919 1532 38 2233 13 523

1995 est 438 57 1103 842 41 1447 1835 40 3207 16 846

Women 35-69 years 70 years

Year Cancer CVD All All

MORT Sm% SAD MORT Sm% SAD MORT Sm% SAD Sm% SAD

1985 182 4 34 311 4 39 667 5 115 0 0

1990 226 5 54 338 6 87 765 6 217 1 37

1995 est 270 6 82 361 9 151 869 8 342 1 50