Banning tobacco sales among young people could prevent 1.2 million lung cancer deaths, study finds

Creating a generation of people who never smoke could prevent 1.2 million lung cancer deaths worldwide, according to a study by researchers at the University of Santiago de Compostela, the International Center for Cancer Research (IARC) and global collaborators published in Lancet Public Health newspaper.

The simulation study, the first of its kind, suggests that banning the purchase of cigarettes and other tobacco products among people born between 2006 and 2010 could prevent 1.2 million lung cancer deaths in 185 countries by 2095.

The results indicate that creating a so-called tobacco-free generation could reduce the impact of smoking on lung cancer deaths in future generations.

Tobacco use is the leading cause of preventable death worldwide. It is the leading risk factor for lung cancer and is estimated to be responsible for more than two-thirds of the 1.8 million deaths from the disease each year.

“Lung cancer is a major cause of death worldwide, and two thirds of deaths are linked to a preventable risk factor: smoking. Our modeling highlights how much there is to gain for governments considering implementing ambitious plans to create a tobacco control system. free generation”, said author Dr Julia Rey Brandariz, University of Santiago de Compostela, Spain.

“Not only could this save a large number of lives, it could significantly reduce the strain on health systems from treating and caring for people who are in poor health due to smoking.”

No country currently has laws prohibiting the sale of tobacco to young people. New Zealand’s groundbreaking legislation banning the sale of tobacco products to anyone born in 2009 or later was recently repealed.

To date, few studies have analyzed the impact of banning the sale of tobacco products on specific age groups or generations, with most focusing on the potential health benefits rather than the death.

The new study is the first to evaluate the effect that implementing a tobacco-free generation would have on future lung cancer deaths. It focused on people born between 2006 and 2010 because the legal age to purchase tobacco products is 18 in most countries included in the analysis.

Future lung cancer mortality rates were predicted based on historical data from 82 countries recorded in the WHO mortality database. These estimated rates were applied to data from the GLOBOCAN 2022 database, a global cancer statistics platform from IARC, to predict lung rates in people born between 2006 and 2010 in 185 countries.

The number of preventable lung cancer deaths linked to smoking was calculated using data from a previous study of lung cancer deaths among people who had never smoked. National level data is available in Annex 8.

The analysis indicates that approximately 1.2 million lung cancer deaths could be avoided in 185 countries if smoking were eliminated among people born between 2006 and 2010. This could prevent 40.2% (1.2 in 2 .9 million) of the total lung cancer deaths expected in this country. birth cohort by 2095.

Nearly half of expected lung cancer deaths in men could be avoided (45.8%, 844,200 out of 1.8 million deaths) and almost a third of expected deaths in women (30.9% , 342,400 out of 1.1 million deaths).

Among men, the greatest number of potential lung cancer deaths averted would occur in upper-middle-income countries (64.1% or 541,100 out of 844,200 deaths). The impact would be greatest in Central and Eastern Europe, where 74.3% of potential deaths (48,900 out of 65,800 deaths) could be avoided.

Among women, the greatest number of potentially avoided deaths would occur in high-income countries (62.0%, or 212,300 out of 342,400 deaths). The greatest impact would occur in Western Europe, where 77.7% of deaths (56,200 out of 72,300 deaths) could be avoided.

Overall, most potentially averted deaths would occur in low- and middle-income countries (LMICs), with estimates suggesting that almost two-thirds of potential averted deaths (65.1% or 772,400 out of 1.2 million ) would occur in these countries. The remaining potential deaths averted would occur in high-income countries, where almost two-thirds of all potential lung cancer deaths (61.1%, 414,100 of 677,600) would be averted.

“Even though smoking rates in high-income countries have declined in recent years, lung cancer remains a leading cause of death and disease. In low- and middle-income countries, where the youth population is growing rapidly, the impact of banning tobacco sales could be even greater,” said author Dr Isabelle Soerjomataram, International Center for Research on cancer,

“Part of the reason that eliminating tobacco use could save so many lives in low- and middle-income countries is that their populations tend to be younger than those in high-income countries. Smoking also remains very common in many of these countries, although rates have fallen. in many high-income countries.

“While we must redouble our efforts to eliminate tobacco use in all regions of the world, this is particularly important in low- and middle-income countries.”

The authors acknowledge certain limitations to their study. It was not possible to take into account all factors affecting implementation, such as the black market or lack of compliance, but the authors conducted more in-depth analyzes to estimate the reduction in health impacts if banning was not completely effective.

Lack of data in some regions meant lung cancer predictions could only be made for 82 countries. Predictions for other countries – mainly low-income countries – may be overestimated or underestimated as they were produced by extrapolation of data based on location and lung cancer burden.

There is little data on lung cancer rates among people who have never smoked – some dating from before the 2000s – which could affect estimates because rates may have changed due to improving health care. The forecasts did not take into account the use of electronic cigarettes.