[Health life years lost due to smoking]

The aim of the study was to estimate health expectancy--that is, the average lifetime in good health--in never smokers, ex-smokers, and smokers in Denmark.

A method suggested by Peto and colleagues in 1992 for estimating smoking-attributable mortality rates was used to construct a life table for never smokers. This table and the relative risks of death for ex-smokers and smokers versus never smokers were used to estimate life tables for ex-smokers and smokers. Life tables and prevalence rates of health status were combined and health expectancy was calculated by Sullivan's method.

The expected lifetime of a 20 year-old man who will never begin to smoke is 56.7 years, 48.7 of which are expected to be in self-rated good health. The corresponding figures for a man who smokes heavily are 49.5 years, 36.5 of which are in self-rated good health. A 20 year-old woman who will never begin to smoke can expect to live a further 60.9 years, with 46.4 years in self-rated good health; if she is a life-long heavy smoker, her expected lifetime is reduced to 53.8 years, 33.8 of which are in self-rated good health. Health expectancy based on long-standing illness is reduced for smokers when compared with never smokers.

Smoking reduces the expected lifetime in good health and increases the expected lifetime in poor health.