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7 countries, 1.3 million lives lost – the devastating impact of tobacco revealed

Jacob Smith
by Jacob Smith | News

16 November 2023

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A stack of cigarettes, one of them smoking

The results of a new study funded by Cancer Research UK reveal that 1.3 million lives are lost to cancers caused by smoking tobacco every year across the UK, US and BRICS nations (Brazil, Russia, India, China and South Africa). 

The study, carried out by researchers from the International Agency for Research on Cancer (IARC), Queen Mary University of London (QMUL) and Kings College London, looked at the impact of four preventable risk factors – smoking, alcohol, overweight or obesity, and human papillomavirus (HPV) infections.  

Combined, these four preventable risk factors caused almost 2 million deaths from cancer in the 7 analysed countries a year. 

Together, the 7 countries analysed represent more than half of the global burden of cancer deaths each year. 

These numbers are staggering, and show that with action on a global scale, millions of lives could be saved from preventable cancers. Action on tobacco would have the biggest impact – smoking causes around 150 cases of cancer in the UK every single day. Raising the age of sale here in England is a critical step on the road to creating the first ever smokefree generation, and we call on MPs from all parties to support the legislation.

There are cost-effective tools at hand to prevent cases of cancer, which will save lives around the world. Tobacco control measures are chronically underfunded. And as a recognised leader in global health, the UK Government can play a significant role in addressing this.  

- Dr Ian Walker, Cancer Research UK's executive director of policy and information

How does each country measure up? 

The study also analysed the years of life lost to cancer. This was calculated by using the age at which cancer patients died from their disease and the average life expectancy for the general population at that age to estimate how many years are lost to cancer. 

This approach allowed researchers to examine whether certain risk factors are causing deaths more prematurely, enabling them to better measure the impact of cancer deaths on society – for example, a cancer death at age 60 will result in more years of life lost than a death at age 80.    

Researchers found that the four preventable risk factors result in over 30 million years of life lost to cancer each year. 

Of those years, smoking tobacco had by far the biggest impact – leading to 20.8 million years of life being lost to cancer each year. 

However, preventable risk factors were predominantly associated with different cancer types in different countries.  

For example, for men in India, most smoking-associated years of lives lost were attributed to head and neck cancer. For women in India and South Africa, gynaecological cancer caused the most years of lives lost. But in every other country, tobacco smoking caused the most years of life to be lost to lung cancer. 

The higher number of years of life lost to head and neck cancer in men in India could be explained by tobacco use being different to the UK, with smokeless or chewed tobacco products more common than smoking cigarettes. 

Cervical screening is less comprehensive in India and South Africa than in some other countries like the UK and US, which would explain why there are more years of life lost from gynaecological cancers due to HPV infection in India and South Africa. 

Cervical cancer can be largely prevented by screening and HPV vaccination, which are more established in the UK and US, with the HPV vaccination in the UK reducing cervical cancer rates by almost 90% in women in their 20s who were offered the vaccine aged 12-13. 

A global effort 

Across the globe, cancer is increasingly impacting low- and middle-income countries. Cancer Research UK analysis shows that new cancer cases are expected to rise by around 400%, from 0.6 million to 3.1 million per year in low-income countries over the next 50 years. Very-high-income countries like the UK are projected to see an increase of around 50% over the same time period. 

“Seeing how many years of life are lost to cancer due to these risk factors in countries around the world allows us to see what certain countries are doing well, and what isn’t working,” says Dr Judith Offman, senior lecturer in cancer prevention and early detection at QMUL, who worked on the study. 

“Globally, someone dies every two minutes from cervical cancer. 90% of these deaths occur in low- and middle-income countries and could be cut drastically with comprehensive screening and HPV vaccination programmes. 

“We know that HPV vaccination prevents cervical cancer. This, coupled with cervical screening, could eliminate cervical cancer as a public health problem. Countries need to come together on this ambition.” 

Cancer Research UK is attempting to address this through its International Cancer Prevention programme, which works with partners in low- and middle-income countries to increase access to the HPV vaccine and support effective tobacco control measures. 

In England, Cancer Research UK is launching its Manifesto for Cancer Research and Care on November 28 to outline how the UK government can transform cancer care and survival in this country, and help other countries around the world save more lives from cancer.  

The manifesto will provide a blueprint of actionable policies that any political party can adopt to improve outcomes for cancer patients.