Recalculation of Tobacco-Attributable Mortality: National and Regional Data for Germany

Abstract

Introduction Tobacco use accounts for about 5 million annual premature deaths worldwide. Tobacco thus is the single most important preventable health risk. In this paper we present a recalculation of tobacco-attributable mortality in Germany, and examine gender and regional differences. Data and Methods The calculation is based on the prevalence of current and former smokers, the relative mortality risks for diseases for which tobacco use is associated with an increased mortality risk, and the number of deaths by ICD-10 diagnoses. For the first time, colorectal and liver cancer as well as type 2 diabetes and tuberculosis were taken into consideration. Results In 2013, 121 087 deaths were attributable to smoking (i. e. 13.5% of all deaths), including 84 782 deaths in men and 36 305 deaths in women. The tobacco-attributable mortality rate was higher in men than in women, and in terms of regional discrepancies a north-south-gradient was observed. Conclusion The number of tobacco-attributable deaths is substantial and higher than previously predicted. Compared to 2007, numbers have increased in absolute terms, whereas in relative terms the tobacco-attributable mortality rate declined. Given processes of demographic aging, a continued rise in absolute numbers of tobacco-attributable mortality is to be expected in the future.