A new study suggests that banning the sale of tobacco products to people born between 2006 and 2010 could prevent 1.2 million lung cancer deaths globally by 2095. This ‘tobacco-free generation’ approach could have a significant impact, especially in low- and middle-income countries. Lung cancer is a leading cause of death worldwide, and smoking is the biggest risk factor. This simulation study highlights the potential benefits of ambitious government policies to create a smoke-free future.
Preventing a Deadly Epidemic
Smoking is the leading preventable cause of death in the world and accounts for more than two-thirds of lung cancer deaths — an estimated 1.8 million deaths globally each year. A new study published in The Lancet Public Health demonstrates that the creation of a ‘tobacco-free generation’ (as prompted by actions like introducing more plain-packaging regulations or banning sweet-style flavours) could result, in time, to an immediate and future alleviation of the burden of lung cancer.
For example, the team examined what would happen if tobacco products could no longer be sold to people who were born between 2006 and 2010 and thus would reach legal age in the vast majority of countries. Their model predicts that this would avert 1.2 million lung cancer deaths (40% of projected deaths in this birth cohort from all causes) in 185 countries through to 2095.
Focus on Developing and Emerging Markets
According to the study, the most profound results of a tobacco-free generation would be experienced in low-and middle-income countries (LMICs), with their growing numbers of young people. In those countries, nearly two-thirds (65.1%) of the potential deaths averted would happen
This is especially important because although smoking prevalence has decreased in high-income countries, it remains high in many LMICs. The impact of such an approach could go a long way in alleviating the global lung cancer burden by directing resources towards those that most need them. As Dr. Isabelle Soerjomataram of the International Agency for Research on Cancer, commented in an Editor’s Note that “one reason why such a large number of deaths could be avoided by ending smoking is because many low- and middle-income countries have younger populations than high-income countries.”
Challenges and Limitations
The researchers note that their study does have some limitations. However, for example, it was not possible to adjust sales ban effect sizes taking all relevant pros and cons of a tobacco sales ban in account (e.g., existence of black market or lower compliance).
Moreover, because data was sparse and incomplete, the researchers could only forecast outcomes for 82 countries – most of their estimates for other countries will be either too-low or too-high. The study also did not account for the uptick in e-cigarette smoking that has occurred more recently.
The study concludes: “Whilst acknowledging the limitations of these data, we estimate that continued strong implementation and renewal of existing MPOWER policies could result in dramatic reductions in smoking prevalence over fewer than 40 years, particularly in low-income and middle-income countries. As Dr. Julia Rey Brandariz from the University of Santiago de Compostela, Spain, said: ‘Not only would this save a great number of lives, but we know from our other research that smoking cessation could greatly reduce the strain on health systems in providing care and support for people with smoking‐attributed sickness.’
