Smoking Habits in Germany

Catering trade, hotel business Construction workers Mining industry, metal processing Driver, taxi driver Painters, varnish workers Unskilled workers Metalworking industry Watchers, security officers Nursing staff, midwifes Shop assistents Typists Management consultants Farmers, stockbreeding, forestry, gardeners Bankers, insurance agents Representatives, administrators Engineers, physicists, chemists, mathematicians Teacher male, female Physicians, pharmacists 10 20 Frequency [] female smokers male smokers 30 40 50 60 Fig. 2.3 ฀฀฀Smoking฀ prevalence฀ in฀ different฀ occupational฀ groups฀ [27] .฀ By฀ kind฀ permission฀ of฀ the฀ German฀Federal฀Statistics฀Ofice Fig. 2.4 ฀฀฀Correlations฀between฀smoking฀behaviour฀and฀average฀gross฀monthly฀income฀for฀men.฀Results฀ of฀the฀Microcensus฀Study฀ [42] 60 Portion of Smokers [] 50 40 30 20 10 700 1,100 18-29 LJ 30-49 LJ 50-64 LJ 65 LJ 1,725 Net income of the Household [ €] 2,500 3,250 3,250 Overall,฀it฀may฀be฀concluded฀that฀a฀very฀highly฀pronounced฀social฀gradient฀exists฀in฀ terms฀of฀smoking฀behaviour฀ [39] .฀Smokers฀tend฀to฀be฀particularly฀from฀households฀with฀a฀ very฀low฀income฀andor฀from฀people฀whose฀primary฀income฀is฀based฀on฀social฀welfare฀or฀ unemployment฀beneit.฀In฀addition,฀the฀Microcensus฀Study฀reveals฀that฀ex-smokers฀are฀ mainly฀from฀households฀with฀a฀higher฀net฀monthly฀income฀ [42] .

2.4 Cigarette-Related Mortality in Different Countries

While฀prospective฀studies฀potentially฀providing฀evidence฀of฀the฀number฀of฀deaths฀related฀ to฀cigarette฀smoking฀would฀be฀unambiguous,฀they฀are฀too฀time-consuming฀and฀costly฀in฀ practice฀and฀are,฀therefore,฀problematic฀to฀conduct.฀Nevertheless,฀this฀dificulty฀can฀be฀ overcome฀by฀using฀survival฀statistics,฀e.g.,฀by฀comparing฀data฀from฀different฀countries฀on฀ lung฀cancer฀mortality฀among฀smokers฀and฀non-smokers.฀The฀correlation฀between฀smoking฀ and฀lung฀cancer฀mortality฀is฀clearer฀in฀developing฀countries฀than฀in฀industrialised฀countries฀ because฀environmental฀factors฀are฀more฀inluential฀in฀the฀latter฀Tables฀ 2.3 ฀and฀ 2.4 . A฀survey฀of฀trends฀for฀mortality฀from฀smoking฀over฀the฀past฀50฀years฀among฀men฀and฀ women฀ in฀ the฀ age฀ category฀ from฀ 35฀ to฀ 69฀ years฀ reveals฀ a฀ pattern฀ that฀ gives฀ pause฀ for฀ thought:฀when฀extrapolated฀to฀the฀coming฀decades,฀smoking-related฀mortality฀for฀men฀and฀ women฀is฀expected฀to฀be฀identical฀Figs.฀ 2.6 ฀and฀ 2.7 ฀ [43] .฀In฀addition,฀when฀calculated฀ with฀reference฀to฀age,฀mortality฀attributable฀to฀smoking฀rises฀disproportionately฀more฀rap- idly฀than฀mortality฀without฀such฀harmful฀exposure฀ [43] .฀The฀data฀summarised฀in฀Tables฀ 2.3 ฀ and฀ 2.4 ฀show฀that฀smoking-related฀mortality฀in฀the฀former฀socialist฀economies฀of฀Eastern฀ Europe฀is฀lower฀than฀that฀in฀the฀industrialised฀countries,฀though฀it฀should฀be฀remembered฀ that฀the฀data฀for฀the฀former฀Eastern฀Bloc฀countries฀may฀be฀incomplete.฀It฀is฀clear฀that฀all฀ state฀ initiatives฀ to฀ stem฀ the฀ smoking฀ tide฀ have฀ not฀ resulted฀ in฀ a฀ reduction฀ in฀ smoking- related฀mortality฀in฀middle฀age.฀Even฀though฀the฀age฀of฀70฀is฀regarded฀as฀a฀signiicant฀ 45 Portion of Smokers [] 40 30 35 20 25 10 15 5 700 1,100 1,720 Net income of the Household [ €] 2,500 3,250 3,250 18-29 LJ 30-49 LJ 50-64 LJ 65 LJ Fig. 2.5 ฀฀฀Correlations฀between฀smoking฀behaviour฀and฀average฀gross฀monthly฀income฀for฀women.฀ Results฀of฀the฀Microcensus฀Study฀ [42] “milestone”฀in฀various฀countries,฀only฀one฀in฀ive฀smokers฀survives฀this฀milestone.฀The฀ opposite฀picture฀is฀found฀in฀the฀OECD฀countries:฀without฀the฀use฀of฀tobacco฀one-ifth฀of฀ people฀die฀before฀reaching฀the฀age฀of฀70,฀and฀deaths฀among฀non-smokers฀before฀the฀age฀of฀ 70฀are฀declining฀all฀the฀time฀ [43] . The฀statistics฀calculated฀for฀1990฀are฀impressive:฀for฀all฀countries฀together,฀mortality฀ from฀smoking฀was฀24฀and฀in฀the฀35–69-year-old฀age฀group,฀mortality฀was฀35฀for฀men฀ and฀12฀for฀women฀ [43] .฀The฀loss฀of฀life฀for฀a฀smoker฀is฀calculated฀at฀5–7฀years.฀In฀ several฀countries฀France,฀the฀Netherlands,฀Sweden,฀there฀has฀been฀an฀increase฀in฀ciga- rette฀consumption฀in฀young฀women฀in฀particular,฀with฀the฀result฀that฀increased฀mortality฀ must฀be฀anticipated฀in฀the฀decades฀ahead฀ [40] ฀Figs.฀ 2.6 ฀and฀ 2.7 .฀The฀summarised฀data฀ indicate฀that฀no฀smoking-related฀deaths฀occurred฀in฀people฀below฀the฀age฀of฀35฀ [43] .฀ Approximately฀ half฀ of฀ all฀ smokers฀ from฀ the฀ developing฀ countries฀ suffered฀ from฀ their฀ smoking฀behaviour.฀Teenagers฀or฀young฀adults฀who฀become฀regular฀smokers฀must฀expect฀ to฀forfeit฀8฀years฀of฀life฀ [43] ,฀as฀also฀shown฀by฀a฀study฀among฀British฀doctors฀conducted฀ over฀a฀40-year฀period฀ [23] . Table 2.3 ฀฀฀Numbers฀and฀percentages฀of฀smoking-related฀deaths฀in฀OECD฀countries฀in฀1990 Country Men Women 35–69฀ years 70฀years All฀ages 35–69฀ years 70฀years All฀ages Australia 6.7฀28 7.3฀21 14.0฀22 1.9฀15 3.1฀8 5.0฀9 Austria 4.0฀28 3.6฀16 7.5฀20 0.6฀7 1.5฀4 2.0฀5 Belgium 7.9฀41 8.6฀28 16.5฀31 0.7฀6 0.6฀1 1.2฀2 Canada 13.5฀35 14.1฀24 27.6฀27 5.0฀23 7.0฀11 12.1฀14 Denmark 3.3฀32 4.3฀22 7.6฀25 1.8฀27 2.6฀11 4.4฀15 Finland 2.6฀25 2.7฀21 5.3฀21 0.2฀5 0.5฀3 0.8฀3 France 32.6฀32 24.5฀16 57.1฀21 1.0฀2 1.2฀1 2.2฀1 Germany 52.0฀32 43.3฀18 95.3฀22 6.2฀7 10.4฀3 16.5฀3 Greece 5.2฀33 5.2฀17 10.4฀21 0.4฀5 0.9฀3 1.3฀3 Ireland 1.7฀31 2.5฀24 4.2฀25 0.7฀20 1.6฀15 2.3฀16 Italy 37.8฀37 34.9฀21 72.7฀26 2.7฀5 7.4฀4 10.1฀4 Japan 26.8฀16 41.5฀16 68.3฀15 3.6฀4 15.4฀6 19.0฀5 Luxemburg 0.2฀34 0.3฀25 0.5฀27 0.1฀9 0.1฀1 0.1฀3 Netherlands 8.6฀38 13.0฀32 21.6฀32 1.4฀11 1.3฀3 2.7฀4 New฀Zealand 1.4฀28 1.7฀22 3.1฀22 0.7฀21 0.8฀9 1.4฀11 Norway 1.4฀21 1.9฀12 3.4฀14 0.4฀12 0.6฀3 1.0฀5 Portugal 4.0฀21 2.8฀9 6.5฀13 0.0฀0 0.0฀0 0.0฀0 Spain 20.5฀33 19.4฀19 40.0฀23 0.0฀0 0.0฀0 0.0฀0 Sweden 2.1฀16 3.2฀9 5.3฀11 0.7฀10 1.3฀3 2.0฀4 Switzerland 3.1฀31 3.7฀18 6.8฀21 0.3฀6 0.9฀3 1.2฀4 United฀ Kingdom 37.2฀35 52.1฀27 89.4฀28 16.4฀24 32.1฀13 48.5฀15 USA 150.0฀36 136.2฀23 286.3฀26 72.7฀28 102.1฀14 174.9฀17 Total 423.5฀32 427.8฀20 851.3฀23 117.7฀16 191.6฀7 309.3฀9 Numbers฀of฀deaths฀in฀1,000s;฀percentages฀in฀parentheses฀ [43]