Research shows that banning the sale of tobacco among young people could prevent 1.2 million deaths from lung cancer

Creating a generation of people who never smoke could prevent 1.2 million deaths from lung cancer worldwide, according to a study led by researchers from the University of Santiago de Compostela, the International Agency for Research on Cancer (IARC) and global contributors published in The Lancet Public Health magazine.

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

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

“Lung cancer is one of the leading causes of death worldwide, and as many as two-thirds of deaths are linked to one preventable risk factor: tobacco smoking. Our models highlight how much there is to gain for governments considering implementing ambitious plans to create a tobacco industry.” free generation,” says author Dr. Julia Rey Brandariz, University of Santiago de Compostela, Spain.

“Not only could this save huge numbers of lives, it could also massively reduce the burden on healthcare systems in treating and caring for people with poor health due to smoking.”

No country currently has laws that make it illegal to sell tobacco to young people. New Zealand’s landmark legislation to ban the sale of tobacco products to anyone born in or after 2009 has recently been repealed.

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

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 for purchasing tobacco products is 18 in most countries included in the analysis.

Future lung cancer mortality rates were predicted based on historical data for 82 countries recorded in the WHO Mortality Database. These estimated figures were applied to data in the GLOBOCAN 2022 database – an IARC global cancer statistics platform – to predict lung rates among people born between 2006 and 2010 for 185 countries.

The number of preventable smoking-related deaths from lung cancer was calculated using data on lung cancer deaths among people who had never smoked from a previous study. Country level data are available in Annex 8.

The analysis shows that in 185 countries, an estimated 1.2 million lung cancer deaths could be prevented if smoking were eliminated among people born between 2006 and 2010. This would be 40.2% (1.2 out of 2.9 million) of the total lung cancer deaths expected to occur in this country. birth cohort in 2095.

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

Among men, the largest number of potential averted deaths from lung cancer would be in upper-middle-income countries (64.1% or 541,100 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.

For women, most potential deaths could be avoided in high-income countries (62.0% or 212,300 of 342,400 deaths). The greatest impact would be 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 of 1.2 million) would occur in these countries . The other potential preventable deaths would occur in high-income countries, where almost two-thirds of all potential lung cancer deaths (61.1%, 414,100 out of 677,600) would be prevented.

“Although the number of smokers in high-income countries has fallen in recent years, lung cancer remains one of the leading causes of death and disease. In low- and middle-income countries, which have rapidly growing populations of young people, the impact of banning tobacco sales could be even greater,” says author Dr. Isabelle Soerjomataram, International Agency for Research on Cancer,

“Part of the reason why eliminating smoking could save so many lives in low- and middle-income countries is because they tend to have younger populations than high-income countries. Smoking also remains very common in many of these countries, while rates have fallen. in many high-income countries.

“While we need to redouble our efforts to eliminate smoking in all parts of the world, this is especially important in low- and middle-income countries.”

The authors acknowledge some limitations of their study. It was not possible to take into account all factors influencing implementation, such as the black market or poor compliance, but the authors conducted further analyzes to estimate the reduction in health impacts if the ban were not fully effective .

Due to lack of data in some regions, lung cancer predictions could only be performed for 82 countries. Predictions for other countries – especially low-income countries – may be over- or underestimated because they are produced by extrapolating data based on location and lung cancer burden.

There was limited data on lung cancer rates among people who had never smoked – some from before the 2000s – which could affect the estimates, as the numbers may have changed due to improvements in health care. The predictions did not take into account the use of e-cigarettes.