Creating a generation of people who never smoke could prevent 1.2 million deaths from lung cancer globally, according to new research.
The simulation study using historical data on 82 countries including New Zealand suggests banning the purchase of cigarettes and other tobacco products among people born between 2006 and 2010 could prevent almost half (45.8%) of future lung cancer deaths in men, and around a third (30.9%) in women in 185 countries by 2095.
The Science Media Centre asked experts to comment.
Professor Richard Edwards, ASPIRE Aotearoa Research Centre, Department of Public Health, University of Otago, Wellington; and co-author of this study, comments:
“Our paper estimates the number of deaths from lung cancer that would be prevented globally if smoking initiation was eliminated (i.e. a tobacco-free generation achieved) among a cohort of people born between 2006-2010. We estimate this figure would be over 1.1m of the almost 3 million expected lung cancer deaths including 11,600 in Australia and New Zealand. . The findings, for just one of the many adverse health impacts of using tobacco products, illustrate the enormous potential reduction in deaths and suffering that could be achieved by preventing uptake of smoking, and demonstrates the importance of introducing robust measures to fully protect young people from the risk of becoming addicted to tobacco products.
“The paper underlines the importance of measures like the recently repealed smokefree generation policy for safeguarding the health of future generations in Aotearoa New Zealand. By repealing this policy which would have prevented the sale of tobacco products to young people born after January 1 2009, the New Zealand Government went backwards on protecting young people from addiction to tobacco products and devastating future health impacts like lung cancer. This is in stark contrast to other jurisdictions around the world that are prioritising the health of future generations by forging ahead with this measure. These jurisdictions include the UK, a growing number of localities in America and most recently South Australia, where a Bill introducing a smokefree generation policy for nicotine and tobacco products passed through the Upper House of the Parliament in the last week.”
Conflict of interest statement: Professor Edwards is a co-author of this research.
Our colleagues at the Spanish Science Media Centre also gathered comments:
Josep Maria Suelves, Head of the Service for the Prevention and Control of Smoking and Injuries at the Public Health Agency of Catalonia and member of the Board of Directors of the National Committee for the Prevention of Smoking, comments:
“What if we were able to protect all those born in the world between 2006 and 2010 from the tobacco industry’s interests so that they would never start smoking? A new study published in Lancet Public Health estimates the impact on lung cancer mortality of the generations born in that period, children and adolescents who will be 18 years old by 2029. From the models used, the authors conclude that such a scenario would lead to the avoidance of 1,186,500 premature lung cancer deaths, representing the number of today’s adolescents who will die from lung cancer in the future if they continue to smoke at the current rate.
“Although lung cancer is not the only disease caused by the use of tobacco and nicotine products, the results of this study help to understand why smoking remains one of the leading preventable causes of poverty, suffering and health loss worldwide, killing eight million people each year. Throughout the 21st century, the World Health Organisation and many states have begun to promote tobacco prevention and control policies that are bearing fruit in some countries, the most advanced of which are beginning to consider limiting access to tobacco to those born after a certain date.
“Envisioning a new stage in public health policies to reach the first tobacco-free generations – known as the End Game– is not a pipe dream, nor can it rely solely on the effectiveness of a ban on tobacco sales to those born after a certain date, It requires continuing to promote other measures of proven effectiveness, such as increasing the price of tobacco products, the introduction of neutral packaging, the extension of places where smoking is prohibited, or the regulation of new tobacco and nicotine products with which the tobacco multinationals seek to attract new addicts in adolescence. In Spain, where tobacco causes more than 50,000 deaths a year, most of these measures are necessary and should be implemented urgently, as the scientific community has been calling for and public institutions have been announcing.”
No conflicts of interest.
Our colleagues at the Irish Science Media Centre also gathered comments:
Prof Frank Doyle, Associate Professor in Psychology, RCSI University of Medicine and Health Sciences, comments:
“This is an excellent study which clearly provides an evidence-based rationale for reducing lung cancer deaths if tobacco smoking was eliminated in people born in the years 2006-2010. There is no reason to think that the estimated lives saved would be much different if applied specifically to an Irish context.
“Tobacco use kills over 5000 people annually in Ireland. According to the Central Statistics Office, over half of deaths in Ireland in 2023 were related to cancers and circulatory diseases – of which smoking are major causes.
“There is no reason to worry about the findings from this paper – it is an exercise in ‘what if’ – what if we could eliminate smoking initiation in younger people. The impact this could have should be seen as a cause for optimism.
“This is a high-quality study using mostly very good data where this was available. Of course, for some low-income countries the exact data is not available, but the researchers estimated this using other results.
“The results are in line with other work which shows that population-level controls of tobacco, such as taxation and advertising bans to reduce consumption and initiation, can profoundly impact health over the longer term for many millions of people.
“I think the important thing to be aware of in this paper is that the authors have only predicted mortality from lung cancer. However, we know that smoking causes lots of other cancers, cardiovascular disease, respiratory diseases, and so on. So, the impact on any such smoking ban for younger people would be even more profound, with many more lives saved over time.
“I see three main weaknesses in this paper. First, the results are an underestimate of the health impacts of eliminating smoking in younger people – because it is a major risk factor for so many diseases, not just lung cancer. Second, the results assume that any such ban can be perfectly enforced – we know that this is not realistic. In fact, other research is showing that while that the prevalence of smoking overall has decreased over time, the rates of smoking are actually increasing in more marginalised groups. There is also always a black market for cigarettes and other substances, so it is unclear how any such ban could be perfectly implemented. Third, we do not yet know if newer trends such as increased rates of vaping could impact lung cancer incidence – there is no data yet on this as typically it takes decades to develop lung cancer. If vaping does lead to lung cancer – and we don’t know if it will – then this paper may overestimate the impact of eliminating smoking in young people.”
Conflict of interest statement: “Prof. Frank Doyle has received research funding from the HSE and the Health Research Board to investigate smoking and its effects, and smoking cessation.”