Banning tobacco consumption among young people could prevent deaths among them and those who come after them on a large scale. A new study published in Lancet Public Health recently gave an idea of the magnitude of the preventable deaths.
An estimated 1,186,500 (40.2 per cent) of 2,951,400 lung cancer deaths in people born between January 1, 2006 and December 31, 2010 could be prevented globally if tobacco smoking was eliminated, the researchers calculated.
Elimination of tobacco smoking in the evaluated birth cohort could prevent a greater number and proportion of lung cancer deaths in male individuals than in female individuals. This is because of higher prevalence and earlier onset of smoking in male individuals.
This disparity by sex was more prominent in southern Africa, northern Africa, eastern Asia, southeast Asia and western Asia. In these regions, the proportion of prevented lung cancer deaths in male individuals was estimated to be 20 percentage points higher than in female individuals.
The researchers, led by Julia Rey Brandariz from the Universidade de Santiago de Compostela in Spain, estimated the impact of eliminating tobacco smoking measured via population impact fractions (PIF) in both sexes to be greater than 50 per cent in eight (47.1 per cent) of 17 world regions, particularly in Europe.
In male individuals, central and eastern Europe had the highest PIF (74.3 per cent) whereas in female individuals, western Europe had the highest PIF (77.7 per cent). Middle Africa was the region with the lowest PIF in both male individuals (2.1 per cent) and female individuals (0.9 per cent).
Estimated PIFs for six regions (western Africa, Latin America and the Caribbean, North America, northern Europe, western Europe, and Australia and New Zealand) were higher in female individuals than in male individuals.
The researchers computed PIF, interpreted as the percentage of lung cancer deaths that could be prevented by stopping the generation born during 2006-2010 from tobacco smoking, by dividing the number of preventable lung cancer deaths by the expected lung cancer deaths in the birth cohort.
The simulation study is the first to evaluate the impact of a tobacco-free generation on lung cancer mortality in any country and estimated the impact of a tobacco-free generation on lung cancer mortality in a birth cohort of people from 185 countries.
The results provide global and national insights into the burden of lung cancer mortality that could be prevented by implementing a restriction on tobacco sales to people born during 2006-1010. The burden of lung cancer mortality attributable to tobacco smoking remains high in many countries and is expected to increase in others. The findings indicate that implementation of a tobacco-free generation could reduce the impact of tobacco smoking on lung cancer mortality in future generations.
Tobacco elimination efforts aim at drastically reducing smoking rates by phasing out tobacco sales based on birth dates, ultimately preventing smoking among younger generations.
Tobacco control is a priority for global public health. Strategies such as the WHO MPOWER measures (monitoring tobacco use; protecting people from tobacco smoke; quitting smoking; warning about the dangers of tobacco; enforcing bans on tobacco advertising, promotion, and sponsorship; and increasing tobacco taxes) have been developed to control poor health outcomes as a result of tobacco use.
However, few countries have the highest level of achievement in the measures.
In the past 10 years, a new strategy to combat poor health outcomes as a result of tobacco use, known as the ‘tobacco endgame’, has emerged. The aim of tobacco-endgame strategies is to accelerate tobacco control by rapidly, equitably, and profoundly reducing the prevalence of tobacco smoking and eliminating it among the population.
One of the measures included in many proposed tobacco-endgame strategies is the ‘tobacco-free generation’, which would restrict the sale and supply of tobacco to people born after a specific year.
New Zealand was a pioneer in the tobacco-free generation strategy by proposing to ban the sale of tobacco to people born on or after January 1, 2009. However, the present government repealed the law in February 2024.
Cities like Balanga (Philippines) and Brookline (US) have also implemented a similar strategy and countries like the United Kingdom are considering implementing one.
In 2008 Balanga City’s Mayor, Jose Enrique S. Garcia III introduced a ban on tobacco products in all public places and public utility vehicles in the city’s University Town area. In 2016, the city council expanded the coverage of Balanga City’s smoke-free ban to cover a further 3 km radius.
The ultimate goal was to prohibit all sales, distribution, use, and advertising or promotion of tobacco and tobacco products. A Smoke-Free Task Force was also created to support enforcement of the law.
Brookline voted in 2020 to ban the sale of tobacco to anyone born after January 1, 2000. The move was fought by the tobacco retailers in court. In March 2024, the Supreme Judicial Court, upheld the ordinance banning the sale of tobacco and e-cigarette products to anyone born after January 1, 2000.