Smoking

Smoking is one of the modifiable risk factors tracked by the IHME Global Burden of Disease Study. The attributable deaths shown here represent the estimated number of deaths that could be prevented if exposure to this risk factor were eliminated or reduced to optimal levels. Understanding risk factor contributions helps prioritize public health interventions and policy decisions.

Risk factor attribution uses comparative risk assessment methodology. A single death may be partially attributed to multiple risk factors, so attributable death counts should not be summed across risk factors. Data covers 204 countries from 1990 to the latest available year.

Tobacco smoking is the leading preventable cause of death worldwide, killing approximately 8 million people each year — including 1.2 million from secondhand smoke exposure. Smoking causes cancers of the lung, oral cavity, oesophagus, bladder, kidney, pancreas, and stomach, as well as cardiovascular disease, COPD, type 2 diabetes, and tuberculosis. Approximately 1.3 billion people currently use tobacco products, with prevalence highest in Southeast Asia, Europe, and the Western Pacific. While smoking prevalence has declined in high-income countries (from approximately 40% in the 1970s to 15-20% today), it remains high or is increasing in low- and middle-income countries, where 80% of the world's smokers live. The tobacco industry aggressively markets to youth, women, and populations in LMICs. Smoking is the single most important risk factor amenable to public health intervention, and tobacco control has been described as the most cost-effective public health investment available.

Smoking contributes to mortality from lung cancer, COPD, ischaemic heart disease, stroke, and 3 other conditions. The magnitude of impact varies by country depending on exposure levels, population demographics, and the availability of preventive and treatment services.

The WHO MPOWER package provides six proven tobacco control policies: Monitor tobacco use, Protect from secondhand smoke, Offer cessation help, Warn about dangers (graphic health warnings), Enforce advertising bans, and Raise taxes on tobacco. Tax increases to at least 75% of retail price are the single most effective measure. Pharmacotherapy (nicotine replacement, varenicline, bupropion) and behavioural counselling support cessation. Plain packaging, point-of-sale display bans, and implementation of the FCTC strengthen the policy environment. E-cigarette regulation remains debated.