The most common preventable cause of death, governments must implement effective policies to prevent tobacco use (reducing initiation and promoting cessation) and involuntary exposure to tobacco smoke in order to save lives. Death registries should collect data on tobacco use status to help assess and monitor national tobacco-related death rates.

    Several Asian and African countries are now in the group of countries in which 25% of male deaths are related to smoking. In 2000, this group mainly consisted of European or North American countries (Tobacco Atlas 3), in several of which the percentage has dropped since then.  Appropriate measures must be in place to reduce smoking related deaths in men and women in all countries, and in particular, to prevent an increase in women’s death in low- and middle-income countries.

    Globally, tobacco use killed 100 million people in the 20th century, much more than all deaths in World Wars I and II combined. Tobacco-related deaths will number around 1 billion in the 21st century if current smoking patterns continue. Among middle-aged persons, tobacco use is estimated to be the most important risk factor for premature death in men and the second most important risk factor in women (following high blood pressure) in 2010–2025. To understand better how to address this issue, tobacco deaths need to be monitored closely, and this can be done best if death registries systematically collect data on tobacco use status. Currently, data on tobacco deaths mostly come from individual epidemiological studies.

Tobacco use increases the risk of death from many diseases; cancer, ischemic heart disease, chronic obstructive pulmonary disease (COPD), and stroke are the most common ones. Lung cancer is the leading cause of cancer death worldwide, killing approximately 1.4 million people globally in 2008. At least 80% of lung cancer deaths are attributable to smoking. Even in Northern Africa, where smoking prevalence has increased more recently, lung cancer is the most common cause of cancer death in men. Not only does tobacco use cause disease, but patients with coronary heart disease, cancer, or several other diseases who continue smoking are also at significantly higher risk of death compared to patients with the same disease who never smoked or who quit smoking after being diagnosed with the disease.

Even for those who smoke 10 or fewer cigarettes per day, life expectancy is on average 5 years shorter and lung cancer risk is up to 20 times higher than in never-smokers. Those who smoke fewer than 4 cigarettes per day are at up to 5 times higher risk of lung cancer. As there is neither a safe tobacco product, nor a safe level of tobacco use, the best way to prevent tobacco-related deaths is to avoid using it. Current smokers greatly benefit from quitting smoking