Global life expectancy is projected to reach 78.3 years by 2050, but a reduction in smoking to 5% could add an extra year for men and 0.2 years for women, a study by the Global Burden of Disease, Injuries and Risk Factors (GBD) Tobacco Forecasting Collaborators reveals.

The study, published in The Lancet Public Health journal, suggests speeding up progress toward ending smoking could deliver substantial population health benefits over the next three decades.

Findings highlight that, based on current trends, global life expectancy will likely rise to 78.3 years by 2050 – up from 73.6 years in 2022. However, if tobacco smoking were to gradually decline from current levels to a rate of 5% in 2050, this would result in one year of additional life expectancy in males and 0.2 years in females.

 In a scenario where tobacco smoking was eliminated from 2023 onwards, this could result in up to 1.5 additional years of life expectancy among males and 0.4 years among females in 2050. In both scenarios, millions of premature deaths would also be avoided.

Key points

• First in-depth forecasts of future worldwide health impacts of smoking reveal potential effects of eliminating smoking on life expectancy and premature deaths by 2050.
• Based on current trends, global smoking rates could continue to decrease to 21.1% in males and 4.18% in females by 2050.
• Analysis indicates accelerating actions towards the elimination of smoking globally would increase life expectancy and prevent millions of premature deaths, resulting in 876 million fewer years of life lost (YLLs).
  Reducing smoking rates to 5% by 2050 would increase life expectancy by one year among males and 0.2 years among females and avoid 876 million YLLs.
• The findings indicate life expectancy by 2050 could be even higher. Had smoking been eliminated in 2023, more premature deaths and up to 2.04 billion YLLs could be avoided, with a forecasted life expectancy increase of 1.5 years for males and 0.4 years for females. 

Smoking is a leading risk factor for preventable death and ill health globally, accounting for more than one in ten deaths in 2021. While rates of smoking have fallen substantially over the past three decades, the pace of decline varies and has slowed in many countries. Cancers, ischemic heart disease, and chronic obstructive pulmonary disease (COPD) are—and will continue to be—the leading causes of premature deaths from smoking. Together, these conditions account for 85% of potentially avoidable years of life lost (YLLs)—a measure of premature deaths.

Several countries have set ambitious goals to reduce smoking rates to below 5% in the coming years. However, there is still significant opportunity to expand and strengthen proven policies and interventions to achieve these targets.

“We must not lose momentum in efforts to reduce, and ultimately eliminate, smoking around the world. Our findings highlight that millions of premature deaths could be avoided by bringing an end to smoking,” senior author, Professor Stein Emil Vollset, of the Institute for Health Metrics and Evaluation (IHME) said.

The new analysis provides in-depth forecasts of the health burden for 204 countries, broken down by age and sex, from 2022 until 2050. It is the first study to comprehensively forecast the health impacts due to smoking for all countries and all causes, as well as on 365 diseases and injuries. The main measure studied was YLLs, a measure of premature deaths, counting each death by the remaining life expectancy at the age of death. For example, if the ideal life expectancy is 91 years, and someone dies at age 50, that would result in 41 YLLs. This is because they lost 41 years that they could have potentially lived.

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