Tobacco use: smoking attributable deaths
Deaths attributable to smoking
Smoking remains a leading cause of preventable disease and premature death. While it is not possible to class any death as wholly attributable to smoking, it is possible to estimate what fraction of deaths can be attributed to smoking using estimated prevalence rates of smoking and associated risk of disease.
The methodology document describes the analysis carried out to calculate smoking attributable deaths, having been reviewed and updated for this and previous years’ figures. Please note that for this March 2024 publication
- The 2022 rates analysis figures are based on 2021 mid-year population estimates. 2022 mid-year population estimates produced by National Records of Scotland were not available at the time of publication. When these become available the relevant analysis will be rerun and if a significant impact on the 2022 figures is seen a planned revision of published statistics will be undertaken.
- COVID-19 restrictions resulted in a change in the Scottish Health Survey methodology and the resulting smoking prevalence for 2021 were lower than expected. As these prevalence rates are used to calculate smoking attributable deaths, it was decided to calculate the 2021 figures using both the 2021 and 2022 prevalence rates. Excel tables therefore include two figures for 2021.
- 2021 (a) - using the 2021 prevalence estimates
- 2021 (b) - using the 2022 prevalence estimates
Note that for the charts shown on this page it is 2021 (a) that is displayed for 2021.
In 2022 smoking accounted for an estimated 8,942 deaths (271 deaths per 100,000 population) in those aged 35 and over in Scotland. Chart 1 shows that there has been a decrease in the rate of smoking attributable deaths in Scotland between 2003 and 2022. (Table 1).
In 2022 the rate for males (362 deaths per 100,000 population) was 1.8 times higher than the rate for females (200 deaths per 100,000 population). Both genders showed a decrease in the rate of smoking-attributable deaths across the full time period (2003-2022), though the decrease was more pronounced in males than females (Chart 1; Table 1).
The rate of smoking-attributable deaths has fallen among all age groups since 2003, with the largest decrease (absolute) in the 35-44 age group. The relative decreases ranged from 21% for those in the 75+ age group to 42% for those in the 35-44 age group (Figure 2; Table 2).
The rates for smoking–attributable deaths in each deprivation category decreased over the period 2008-2022, with the least deprived areas having larger percentage decreases than more deprived areas (42% decrease in the least deprived, 21% in the most deprived) (Table 3). In 2022 rates for smoking-attributable deaths in the most deprived areas were over four times higher than in the least deprived areas.
The 8,942 smoking-attributable deaths in Scotland account for 21% of all deaths in 2022 (see Table 4). Smoking-attributable deaths due to cancer (4,630) accounted for 27.8% of all cancer deaths in Scotland in 2022. Smoking-attributable deaths due to respiratory disease (2,314) accounted for 25.9% of smoking attributable deaths and 37.9% of all deaths attributable to respiratory disease.
A larger proportion of deaths among men than women were attributable to smoking, with an estimated 24.1% (5,275) of all deaths among men aged 35 and over being attributable to smoking in 2022. This compares with 17.6% (3,666) of all deaths among women aged 35 and over in 2022 (Table 4).
For both males and females, cancer was the cause of the largest number of smoking-attributable deaths. Of all deaths for men due to cancer in 2022, there were 2,845 (32.7%) estimated to be due to smoking (192 deaths per 100,000 population), while the equivalent number for women was 1,785 (22.3%) (98 deaths per 100,000 population). Numbers of smoking-related deaths were higher for males in all disease categories except for respiratory where females were higher. (Table 4).
Chart 4 shows the number of deaths attributable to smoking in Scotland as a proportion of all deaths split by gender for four groupings of mortality related to smoking (respiratory, cancer, circulatory and digestive) for 2022.
