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European Union: ecological study of evolving tobacco epidemics
Jul 23, 2005, 01:38, Reviewed by: Dr.
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By BMJ-British Medical Journal,
Among men, lung cancer deaths are now falling in most EU countries, including all new member states from central and eastern Europe, but they are still rising among women, find researchers in this week's BMJ.
Tobacco remains Europe's single biggest cause of preventable death, and tobacco related diseases cause 650,000 unnecessary deaths every year in the EU.
The research team calculated lung cancer deaths in the 15 original EU member states and new members from central and eastern Europe. These figures can provide a useful measure of a population's exposure to smoking, especially among 35-54 year olds, when around 80-90% of cases are caused by smoking.
They found that most EU countries are now experiencing falling death rates from lung cancer in men. Only four countries (Portugal, Greece, Spain, and France) show no evidence of a decline across the 35-54 age range.
In contrast, mortality from lung cancer in women is still rising in most EU countries, except for the United Kingdom and, to some extent, Ireland and Denmark. The greatest increases were in France, Spain, and Hungary.
Rates for women in Hungary exceeded those for women in all other member states (mirroring those for Hungarian men) and also exceed the rates for men in more than half the states in the EU.
The authors suggest that product modification may have contributed to the declining prevalence in young men. In Poland, for example, tar yields fell by more than half between 1984 and 1999, and other changes to cigarettes have been made.
Lung cancer epidemics among women show no consistent pattern that follows those in men, add the authors. The very high mortality figures for Hungary merit further investigation.
Throughout Europe, tobacco companies have proved adept at expanding and maintaining their markets, especially among women, say authors of an accompanying commentary. Despite having declined, tobacco related deaths in males remain frighteningly high.
It's time for Europe's doctors to treat tobacco dependence in their patients. But it's also time to move out of the consulting room and demand that our governments take effective action too, they conclude. 
- Lung cancer mortality at ages 35-54 in the European Union: ecological study of evolving tobacco epidemics, BMJ Volume 331, pp 189-91/Commentary: Making the transition to action BMJ Volume 331, pp 191-2
http://www.bmj.com/
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