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This study, published in the Lancet Public Health aimed to look at how much lower lung cancer rates would be in in younger people if smoking was eliminated. They looked at the rate of lung cancer deaths in each of 185 countries, and compared that to the rate in people who never smoked. They found that 1.2 million fewer deaths would happen worldwide if that age group were smoking free. However, it’s worth bearing in mind this study does not suggest that a 100% ban is possible, it is just looking at the hypothetical effect that it might have.
Prof Frank Doyle, Associate Professor in Psychology, RCSI University of Medicine and Health Sciences, said:
“This is an excellent study which clearly provides an evidence-based rationale for reducing lung cancer deaths if tobacco smoking was eliminated in people born in the years 2006-2010. There is no reason to think that the estimated lives saved would be much different if applied specifically to an Irish context.
Tobacco use kills over 5000 people annually in Ireland. According to the Central Statistics Office, over half of deaths in Ireland in 2023 were related to cancers and circulatory diseases – of which smoking are major causes.
There is no reason to worry about the findings from this paper – it is an exercise in ‘what if’ – what if we could eliminate smoking initiation in younger people. The impact this could have should be seen as a cause for optimism.
This is a high-quality study using mostly very good data where this was available. Of course, for some low-income countries the exact data is not available, but the researchers estimated this using other results.
The results are in line with other work which shows that population-level controls of tobacco, such as taxation and advertising bans to reduce consumption and initiation, can profoundly impact health over the longer term for many millions of people.
I think the important thing to be aware of in this paper is that the authors have only predicted mortality from lung cancer. However, we know that smoking causes lots of other cancers, cardiovascular disease, respiratory diseases, and so on. So, the impact on any such smoking ban for younger people would be even more profound, with many more lives saved over time.
I see three main weaknesses in this paper. First, the results are an underestimate of the health impacts of eliminating smoking in younger people – because it is a major risk factor for so many diseases, not just lung cancer. Second, the results assume that any such ban can be perfectly enforced – we know that this is not realistic. In fact, other research is showing that while that the prevalence of smoking overall has decreased over time, the rates of smoking are actually increasing in more marginalised groups. There is also always a black market for cigarettes and other substances, so it is unclear how any such ban could be perfectly implemented. Third, we do not yet know if newer trends such as increased rates of vaping could impact lung cancer incidence – there is no data yet on this as typically it takes decades to develop lung cancer. If vaping does lead to lung cancer – and we don’t know if it will – then this paper may overestimate the impact of eliminating smoking in young people. ”
‘Estimated impact of a tobacco-elimination strategy on lung cancer mortality in 185 countries: a population-based birth cohort simulation study” by name of J. Brandariz et al. was published in The Lancet Public Heath at 23:30 Irish time on 2nd October.
Declared interests
Prof. Frank Doyle: has received research funding from the HSE and the Health Research Board to investigate smoking and its effects, and smoking cessation