Rapid action to eliminate smoking globally could significantly increase life expectancy and prevent millions of premature deaths by 2050, according to a new study published in The Lancet Public Health. The research provides the first in-depth global forecasts of smoking-related health impacts, suggesting that a concerted effort to reduce smoking rates to 5% by 2050 could lead to profound public health benefits.


The study, conducted by the Global Burden of Disease, Injuries and Risk Factors (GBD) Tobacco Forecasting Collaborators, models various scenarios to project future global smoking trends and their effects on population health. 


According to the findings, if smoking rates continue to decline at their current pace, global smoking prevalence could drop to 21.1% in men and 4.18% in women by 2050. At this rate, findings from the study suggest, life expectancy could rise to 78.3 years these 25 years — up from 73.6 years in 2022. However, if global smoking rates are reduced to 5% in that time frame, the analysis predicts an additional one year of life expectancy for men and 0.2 years for women.


This reduction would also prevent an estimated 876 million years of life lost (YLLs) — a measure of premature death — by 2050. If smoking had been eliminated entirely starting in 2023, the study suggests even greater benefits: up to 2.04 billion YLLs could have been avoided, with life expectancy increasing by 1.5 years for men and 0.4 years for women.


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Global Health Toll Of Smoking 


Smoking remains one of the leading causes of preventable death worldwide, responsible for more than one in ten deaths in 2021. While significant progress has been made in reducing smoking rates over the past three decades, the pace of decline has slowed in many regions, leaving millions vulnerable to smoking-related diseases. Cancers, heart disease, and chronic obstructive pulmonary disease (COPD) remain the top causes of death linked to smoking, together accounting for 85% of avoidable years of life lost.


Despite these challenges, several countries have set ambitious goals to lower smoking rates to below 5%, aiming to achieve this target in the coming decades. Authors of the study stress that continued global cooperation and the implementation of proven tobacco control policies are vital to accelerating the decline of smoking.


"We must not lose momentum in efforts to reduce, and ultimately eliminate, smoking around the world," said Professor Stein Emil Vollset of the Institute for Health Metrics and Evaluation (IHME), senior author of the the study. "Our findings highlight that millions of premature deaths could be avoided by bringing an end to smoking."


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Significant Gains For Health, Life Expectancy 


The study used IHME’s Future Health Scenarios platform, incorporating data from the GBD study to predict the health impacts of smoking in 204 countries. The researchers examined different scenarios: the most likely future trend based on current smoking rates, a scenario in which smoking rates fall to 5% by 2050, and a hypothetical scenario in which smoking was eliminated worldwide in 2023.


In the most optimistic scenario, where smoking ends in 2023, life expectancy for men is forecast to rise to 77.6 years by 2050, while women could reach an average life expectancy of 81 years. Even the more conservative scenario of reducing smoking to 5% by 2050 would result in significant gains, with men expected to live an average of 77.1 years and women 80.8 years.


The analysis revealed considerable regional differences in smoking prevalence. In 2050, the smoking rate for men is expected to range from 3.18% in Brazil to 63.2% in Micronesia, while rates for women could range from 0.5% in Nigeria to 38.5% in Serbia.


Funded by Bloomberg Philanthropies and the Bill & Melinda Gates Foundation, the study also acknowledges certain limitations. For instance, the analysis focused on the direct effects of smoking reductions and did not assess the impact of second-hand smoke or the health effects of e-cigarettes. It also did not consider potential advancements in healthcare, such as improved cancer detection and treatment, which could further influence outcomes.