Mortality from tobacco use is increasing among women and decreasing among men

Tobacco is the substance that causes the most deaths and preventable disability in the world. According to the World Health Organization, more than 8 million people die from it every year, mainly from cancer, cardiovascular disease and lung disease. WHO estimates that 500,000 people die each year in Latin America and the Caribbean. And in Spain there are about 50,000.

Some of the health effects of tobacco use, such as respiratory symptoms, appear soon after the start of use. However, there are others that take years to develop, such as cancer. For this reason, monitoring how many people die from smoking, smoking, or even just exposure to secondhand smoke is important and should be done on a regular basis.

Women started smoking later

The expansion of tobacco use in Spain came later than in other developed countries such as the US or the UK. It was only during the Civil War (1936-1939) that smoking became popular among Spanish men, first among the most privileged social classes and then among the working class.

The same pattern was observed in women, but decades later, since until the 1960s, women’s smoking was condemned by society. However, that all changed between the late 1960s and early 1970s, with a significant increase in tobacco use among Spanish women.

Trends in tobacco-related deaths in Spain

One of the most common ways to estimate the impact of tobacco on a population is to calculate smoking-related mortality. This indicator is related to the prevalence of tobacco use and the risk of death of smokers and ex-smokers as a result of smoking.

To analyze how tobacco-related deaths are changing in Spain, a study was conducted to estimate the burden of tobacco-related deaths over a nearly 30-year period (1990-2018).

During this period, tobacco use caused more than 1.7 million deaths, of which more than 1.5 million died among men. Overall, evidence suggests that tobacco-related deaths are declining in Spain.

Looking at the data in detail, this decline is due to a clear decline in tobacco-related deaths among men of all ages since the late 1990s, but if we look only at the female population, things change dramatically. Since the 1990s, tobacco-related deaths among women have been on the rise, especially due to lung cancer and cardiovascular disease. And it does so quickly in both the young and the elderly.

Of particular concern to women is the increase in mortality from lung cancer, which has gained great fame in recent years. So, if in the first half of the study period (1990-2003) lung cancer accounted for 12.3% of the total attributed mortality of women, then in the second half (2004-2018) it almost doubled, reaching 21% of the total.

Moving towards a tobacco-free society

Tobacco use is responsible for a large number of deaths each year, and although this mortality has always been higher among men, the recent evolution of tobacco-related mortality among women is alarming.

It is true that great progress has been made in the field of public health in Spain with the adoption of Laws 28/2005 and 42/2010 on sanitary measures against smoking. But this is not enough: both the percentage of smokers and the death rates associated with tobacco use are still high in Spain.

For this reason, in order to continue to fight the tobacco epidemic, it is necessary to update and strengthen policies to combat it, especially strategies aimed at preventing the initiation and cessation of both conventional tobacco use and new forms of tobacco use. Whereas, these strategies should be designed with an equity and gender perspective.

The article was made on the recommendation of the Spanish Society of Epidemiology.

Monica Perez Rios, Professor, Department of Preventive Medicine and Public Health, University of Santiago de Compostela; Agustin Montes Martinez, University Professor of Preventive Medicine and Public Health, University of Santiago de Compostela and Julia Rae Brandaris, epidemiology and public health researcher, University of Santiago de Compostela

This article was originally published on The Conversation. Read the original.