[Tobacco-attributable mortality in Germany and in the German Federal States - calculations with data from a...

Smoking is the single most important health risk, and annually about five million premature deaths worldwide are attributed to smoking. The aim of this study is to estimate the number of smoking attributable deaths for Germany and its 16 states (Länder) and to assess the regional differences of smoking prevalence and smoking-attributable mortality.

The smoking-attributable mortality is estimated on the basis of (1) smoking and ex-smoking prevalence, (2) the number of deaths by ICD-10 for diseases for which smokers have an increased mortality risk, and (3) the relative mortality risks for smokers and ex-smokers for these diseases.

According to the calculations, 106 623 deaths in Germany in 2007 are attributable to smoking, 77 588 deaths in men and 29 035 in women. This means that 13% of all deaths of people over 35 and of children under age 1 are attributable to smoking (20.2% in men, 6.7% in women).

The state-specific differences of the smoking-attributable mortality rate indicate a north-south-gradient. This gradient is more significant in men, whereas in women there are also some eastern states with a low smoking-attributable mortality. Overall, there is still a high burden of tobacco-related deaths in Germany which leads to considerable costs for the German health system and economy.