1. Deaths from smoking
in Norway
Deaths from smoking
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in Norway

2. Deaths from smoking in Norway
• This presentation provides estimates of the number of deaths caused by smoking in Norway
Particular emphasis is given to the number of deaths in middle age (defined as ages 35 to 69)
Available on
Deaths from smoking in Norway
This presentation provides estimates of the number of deaths caused by smoking. (It excludes any deaths among non-smokers from environmental tobacco smoke.)
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Particular emphasis is given to the number of deaths in middle age
Smoking kills relatively few people before middle age, but many smokers are killed by tobacco while still in middle age (which in this presentation always means 35 to 69 years of age). On average, those killed in middle age lose many years of life, while those killed at older ages might well have died quite soon of something else.
Available on
The website also provides the original statistics from which these estimates have been made, presentations for other countries and further material on the impact of smoking on premature death.

3. Source of data: “Mortality from Smoking in Developed Countries, 1950–2000”
• Updated edition of a 1994 book, authored by an international team of scientists:
– Richard Peto, Professor of Medical Statistics, University of Oxford
– Alan Lopez, Professor of Medical Statistics, University of Queensland
– Jillian Boreham, Senior Research Fellow, University of Oxford
– Michael Thun, Chief of Epidemiology, American Cancer Society
Source of data: “Mortality from Smoking in Developed Countries, ”
Updated edition of a 1994 book …
In 1994, an international team of scientists produced a book that calculated separately the approximate numbers of deaths from smoking in each developed country. (Developed countries are those designated ‘developed’ by the United Nations in 1993.)
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Uses WHO mortality data …
They based their analyses on the national death rates from lung cancer and from various other diseases. (Using World Health Organization mortality data and United Nations population data.) Their findings have been generally accepted and widely used. The website also contains details of their methods.
Uses WHO mortality data for lung cancer and for other diseases, and UN population data

4. Norway
Deaths from smoking, 1950 to 2000
• About 132,000 people died from smoking during this 50-year period in Norway
About half (66,000) of them were still in middle age when they died
This was about one in eight of all the deaths in middle age during this period (66,000 out of the 536,000 deaths at ages 35-69)
Deaths from smoking, 1950 to 2000
About 132,000 people died from smoking during this 50-year period.
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About half (66,000) of them were still in middle age when they died (which is defined as 35-69)
This was about one in eight of all the deaths in middle age during this period (66,000 out of the 536,000 deaths at ages 35-69)

5. Annual deaths from smoking
Norway, year 2000
Annual deaths from smoking
• Smoking kills about 5,500 people a year in Norway
About 1,800 die in middle age from smoking
Many of those killed in middle age would have lived on for 10, 20, 30 or more good years
About 23 years of life are lost, on average, by those killed in middle age by smoking
Annual deaths from smoking
Smoking kills about 5,500 people a year.
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About 1,800 die in middle age from smoking
Many of those killed in middle age …
Of course, some of those killed by smoking in middle age might have died soon anyway from another cause, but some would have lived on for 10, 20, 30 or more good years.
About 23 years of life are lost …
Those who are killed while still in middle age lose, on average, about 23 years. (Of course, this is not the same as saying that all smokers lose 23 years of life expectancy. This applies only to the smokers who are killed in middle age by the habit.)

6. Norway, year 2000
Smoking causes about twice as many deaths as all non-medical causes put together
5,500 smoking
2,368 * non-medical
Murder / assault Falls
Suicide Drowning
Road accidents Poisoning
Plane crashes Fires
Train crashes Floods / storms
Accidents at work Other natural disasters
Accidents at home Other accidents
*in year 2000
Smoking causes about twice as many deaths as all non-medical causes put together
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[White bar and text appear to indicate non-medical deaths]
2,368 non-medical
Understandably, sudden deaths from non-medical causes - such as murder, accidents and natural disasters - capture our attention and the attention of the media, especially since some of them occur well before middle age. This 2,368 is the total number of deaths from all non-medical causes recorded for the year 2000.
[Orange bar and text appear to indicate deaths from smoking]
5,500 smoking
And this 5,500 is the number of deaths from smoking in the same period. The deaths from smoking may not be as newsworthy, but they are just as real, whether they are from lung cancer, or from the many other diseases that smoking can cause.

7. Smoking kills 5,500 people a year, from many different diseases
Norway, year 2000
Smoking kills 5,500 people a year, from many different diseases
*includes 1,500 (85%) of the 1,773 lung cancer deaths
2,100 cancer*
700 other
1,300 respiratory
1,400 vascular
(heart disease,
stroke and other diseases of the arteries and veins)
Smoking kills about 5,500 people a year, from many different diseases
[Pie-chart builds in sections on each click]
[CLICK] 2,100 cancer and lung cancer footnote: Smoking causes many deaths from cancer. It is a cause of most of the lung cancer deaths in the world and it also causes some deaths from cancer of other parts of the body, including the mouth, throat, stomach, pancreas, liver and bladder.
(This includes 85% of the lung cancer deaths. There is a relatively small number of lung cancer deaths that are not caused by smoking. Indeed, even among smokers, a few of the lung cancer deaths are not caused by smoking. Still, however, the large majority of all lung cancer deaths are caused by smoking.)
[CLICK] 1,400 vascular: Smoking causes even more deaths from other diseases than from cancer. Two of the most important consequences are heart disease and stroke, but smoking can also cause other vascular diseases (that is, other diseases of the arteries and veins).
[CLICK] 1,300 respiratory: Smoking can cause death from emphysema, chronic obstructive lung disease, pneumonia and influenza. It even makes people more likely to die from TB (pulmonary tuberculosis), because it damages the defences of the lungs against infection.
[CLICK] 700 other: The “other” deaths from smoking shown here include some deaths from diseases such as stomach ulcer, and many of the deaths that were partly due to cancer, vascular or respiratory disease but did not get attributed to this on the death certificate. None of the deaths from fire or other non-medical causes have been attributed to smoking.

8. About one in five of all cancer deaths is due to smoking
Norway, year 2000
About one in five of all cancer deaths is due to smoking
10,400
total cancer deaths
2,100 (20%)
from smoking
5,500
male
4,900
female
700 (14%)
from smoking
1,400 (25%) from smoking
About one in five of all cancer deaths is due to smoking
[CLICK] [White bar appears to indicate total male and female cancer deaths]
There are 10,400 cancer deaths a year. (Total cancer deaths means all deaths, male or female, at any age from malignant neoplasms.)
[CLICK] [Orange bar appears to indicate proportion caused by smoking]
Of these, 2,100 (20%) are caused by smoking. Smoking is responsible for more cancer deaths than all other known causes of cancer put together (that is, the effect of smoking on cancer mortality is bigger than the sum of all the reliably known effects of other causes on cancer mortality).
[CLICK] [White bar appears to indicate total male cancer deaths]
Among males, there are 5,500 cancer deaths a year.
Of these, 1,400 (25%) are caused by smoking. Because men have smoked cigarettes for many decades, the proportion of cancer deaths caused by smoking is even bigger among males.
[CLICK] [White bar appears to indicate total female cancer deaths]
Among females, there are 4,900 cancer deaths a year.
Of these, 700 (14%) are caused by smoking. At present, the proportion of female cancer deaths that is caused by smoking is misleadingly low. For, the cancer deaths in middle and old age today reflect the smoking habits of young adults several decades ago.
Many of today’s older women were not smoking when they were young. However, many young women do now smoke, and will get killed by tobacco if they continue to smoke. (Indeed, taking cancer and other diseases together, if women smoke like men, then eventually they will die like men.)

9. Male deaths in middle age from smoking
• The main pattern of increase and, eventually, decrease in premature deaths from smoking is at a more advanced stage among men than among women
This pattern is seen first in middle age, then in old age
The next three slides concentrate on male deaths in middle age
Male deaths in middle age from smoking
[CLICK] The main pattern of increase …
The main increase and, eventually, decrease in the death rates from tobacco in many countries is seen first among men and then among women.
[CLICK] This pattern is seen first in middle age, then in old age
[CLICK] The next three slides concentrate on male deaths in middle age

10. About one in five of all deaths in middle-aged men is due to smoking*
Norway, year 2000
About one in five of all deaths in middle-aged men is due to smoking*
About one in five of all deaths in middle-aged men is due to smoking
[Five male figures appear, with one coloured orange]
Smoking caused 1,200 (23%) of the 5,300 deaths at ages that were recorded in the year 2000.
*1,200 (23%) of the 5,300 deaths at ages 35-69

11. Of 100 men aged 35 years … • 22 die in middle age*
Norway, year 2000
Of 100 men aged 35 years …
*risks at year 2000 death rates for ages 35-69
• 22 die in middle age*
22%
• 5 of these 22 deaths are from smoking 5
Of 100 men aged 35 years …
[A grey bar appears to indicate 100 men aged 35 years]
At current death rates, what would be expected to happen among 100 men aged 35 years? How many would die in middle age (that is, at ages 35-69)?
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22 would die in middle age
Overall, 22 would die in middle age (that is, there is a 22% risk of dying in middle age)
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5 of these …
And 5 of these 22 deaths would be from smoking. That is a calculation for the country as a whole, including both smokers and non-smokers. The risks just among the smokers are, of course, even greater.
These are the risks of death in middle age at current death rates. What would these same risks have been at the death rates recorded in previous decades?

12. Male death in middle age: changing hazards*
Norway,
Male death in middle age: changing hazards* 2
Smoking 3 4 5 6 7
29%
All causes
30%
33%
34%
32%
31%
26%
22%
*risks at period-specific death rates for ages 35-69
1955
1960
1965
1970
1975
1980
1985
1990
1995
2000
Norway,
Male death in middle age: changing hazards
[Grey bars appear to indicate 100 men aged 35 years for each of the years for which data are available]
Again, consider what would have happened to 100 men aged 35, at the death rates of previous decades …
[CLICK] [White bars appear with a percent number in black on each one]
Here we have the overall probabilities of death in middle age from any cause. There were some striking changes in male mortality from one period to another. How much of the risk of early death in each period was caused by smoking?
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This much! (Comment on the highest rates of deaths from smoking and on the trend in recent years. Close by re-emphasizing the results for the year 2000.)
The reason smoking matters is because it is responsible for such a big proportion of all premature deaths, and these are deaths of real people.

13. Summary for the whole population
Norway, year 2000
Summary for the whole population
In Norway:
Smoking kills about 5,500 men and women every year
About 1,800 die in middle age from smoking
Smoking causes about twice as many deaths as all non-medical causes put together
About one in five of all cancer deaths is due to smoking
Summary for the whole population
In Norway:
To re-cap, here are some of the key estimates for Norway
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Smoking kills about 5,500 men and women every year
About 1,800 die in middle age from smoking
Smoking causes about twice as many deaths as all non-medical causes put together
About one in five of all cancer deaths is due to smoking
These numbers of deaths reflect the risk for the whole population. Of course, the risks just among the smokers are even greater.

14. Messages for the individual smoker
• The risk is big: about half are killed
Those killed in middle age lose many years
Stopping smoking works
Even in early middle age, those who stop (before they have lung cancer or some other fatal disease) avoid most of their risk of being killed by tobacco
Stopping before middle age works even better
Messages for the individual smoker
The risk is big: about half are killed
There are a few main messages for the individual smoker. First, the risk of death due to smoking is big. The reason smoking matters is not just because it’s dangerous, but because it’s so dangerous; about half of all persistent cigarette smokers are eventually killed by their habit.
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Those killed in middle age lose many years
Second, many are killed while still only in middle age (that is, at years of age), and many of those killed in middle age could have lived on for another 10, 20, 30 or more good years.
Stopping smoking works
And, finally, stopping smoking works. Both for those who already smoke, and for those who will start to smoke in the future, what matters is not only the hazards of smoking but also the benefits of stopping.
For the population as a whole, a big decrease over the next decade or two in the number who start smoking will produce a big decrease in deaths around the middle and the second half of the present century. A big decrease in tobacco deaths in the first half of the century, however, requires many smokers to stop.

15. Deaths from smoking: an electronic resource
Published by
International Union Against Cancer (UICC), Geneva: Switzerland, 2006
Funded by
Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), University of Oxford
International Union Against Cancer (UICC)
Fogarty International Center, US NIH
UK Medical Research Council
Cancer Research UK
Project team Richard Peto, Judith Watt, Jillian Boreham
Project management Sinéad Jones
Advice and support Steve Woodward, Konrad Jamrozik, Lesley Walker, Trish Cotter
Design bwa-design.co.uk