TY - JOUR
T1 - The combined impact of smoking, obesity and alcohol on life-expectancy trends in Europe
AU - Janssen, Fanny
AU - Trias-Llimós, Sergi
AU - Kunst, Anton E.
N1 - Publisher Copyright: © 2021 The Author(s). Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2021/6/1
Y1 - 2021/6/1
N2 - Background: Smoking, obesity and alcohol abuse greatly affect mortality and exhibit a distinct time dynamic, with their prevalence and associated mortality rates increasing and (eventually) declining over time. Their combined impact on secular trends in life expectancy is unknown but is relevant for understanding these trends. We therefore estimate the combined impact of smoking, obesity and alcohol on life-expectancy trends in Europe. Methods: We used estimated national age-specific smoking-, obesity-A nd alcohol-attributable mortality fractions for 30 European countries by sex, 1990-2014, which we aggregated multiplicatively to obtain lifestyle-attributable mortality. We estimated potential gains in life expectancy by eliminating lifestyle-attributable mortality and compared past trends in life expectancy at birth (e0) with and without lifestyle-attributable mortality. We examined all countries combined, by region and individually. Results: Among men, the combined impact of smoking, obesity and alcohol on e0 declined from 6.6 years in 1990 to 5.8 years in 2014, mainly due to declining smoking-attributable mortality. Among women, the combined impact increased from 1.9 to 2.3 years due to mortality increases in all three lifestyle-related factors. The observed increase in e0 over the 1990-2014 period was 5.0 years for men and 4.0 years for women. After excluding lifestyle-attributable mortality, this increase would have been 4.2-4.3 years for both men and women. Conclusion: Without the combined impact of smoking, obesity and alcohol, the increase over time in life expectancy at birth would have been smaller among men but larger among women, resulting in a stable increase in e0, parallel for men and women.
AB - Background: Smoking, obesity and alcohol abuse greatly affect mortality and exhibit a distinct time dynamic, with their prevalence and associated mortality rates increasing and (eventually) declining over time. Their combined impact on secular trends in life expectancy is unknown but is relevant for understanding these trends. We therefore estimate the combined impact of smoking, obesity and alcohol on life-expectancy trends in Europe. Methods: We used estimated national age-specific smoking-, obesity-A nd alcohol-attributable mortality fractions for 30 European countries by sex, 1990-2014, which we aggregated multiplicatively to obtain lifestyle-attributable mortality. We estimated potential gains in life expectancy by eliminating lifestyle-attributable mortality and compared past trends in life expectancy at birth (e0) with and without lifestyle-attributable mortality. We examined all countries combined, by region and individually. Results: Among men, the combined impact of smoking, obesity and alcohol on e0 declined from 6.6 years in 1990 to 5.8 years in 2014, mainly due to declining smoking-attributable mortality. Among women, the combined impact increased from 1.9 to 2.3 years due to mortality increases in all three lifestyle-related factors. The observed increase in e0 over the 1990-2014 period was 5.0 years for men and 4.0 years for women. After excluding lifestyle-attributable mortality, this increase would have been 4.2-4.3 years for both men and women. Conclusion: Without the combined impact of smoking, obesity and alcohol, the increase over time in life expectancy at birth would have been smaller among men but larger among women, resulting in a stable increase in e0, parallel for men and women.
KW - Europe
KW - Health behaviour
KW - life expectancy
KW - lifestyle
KW - mortality
KW - time trends
UR - http://www.scopus.com/inward/record.url?scp=85112123947&partnerID=8YFLogxK
U2 - https://doi.org/10.1093/ije/dyaa273
DO - https://doi.org/10.1093/ije/dyaa273
M3 - Article
C2 - 33432332
SN - 0300-5771
VL - 50
SP - 931
EP - 941
JO - International journal of epidemiology
JF - International journal of epidemiology
IS - 3
ER -