Future smoking-attributable and all-cause mortality: its sensitivity to indirect estimation techniques

Smoking has been the most important non-linear determinant of mortality in low-mortality countries. With changes in smoking behaviour, projections of smoking-attributable and of all-cause mortality including smoking become more important, especially for health care programs and insurance. However, these projections might be sensible to the indirect techniques to estimate smoking-attributable mortality being used.

We estimate future smoking-attributable and all-cause mortality and analyse its sensitivity to different indirect techniques for estimating smoking-attributable mortality.

Future smoking-attributable mortality is obtained by applying different indirect estimation methods to projected lung cancer mortality, e.g. Peto-Lopez and, Preston-Glei-Wilmoth methods. Lung cancer mortality rates are extrapolated using age-period-cohort analysis. Non-smoking related mortality is projected using the Lee-Carter model.

Smoking-attributable mortality will further decline for males and first increase but then decline for females. The different indirect estimation techniques have an effect on smoking-attributable mortality levels and its age structure. Furthermore, they will lead to higher differences in projected smoking-attributable and all-cause mortality for women because of their shorter history in smoking.