Tobacco use: smoking attributable admissions
Hospital Admissions attributable to smoking
Smoking remains a leading cause of preventable disease and premature death. While it is not possible to class any hospital admission as wholly attributable to smoking, it is possible to estimate what fraction of admissions 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 hospital admissions, having been reviewed and updated for this and previous years’ figures. Please note that for this 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 admissions, 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 it is 2021 (a) that is displayed for 2021.
In this section two measures of smoking-attributable hospital admissions for patients aged 35 and over will be reported, as follows:
- Narrow measure – where a smoking-attributable disease or condition was the primary reason for hospital admission.
- Broad measure – where a smoking-attributable disease or condition was the primary or secondary reason for hospital admission.
The narrow measure is a better indicator of changes over time because it is less affected by changes in the completeness of recording of secondary reasons (diagnoses) for admission to hospital.
The broad measure is a better indicator of the total burden that smoking has on health because it provides more complete information.
In 2022 there were an estimated 44,573 smoking-attributable hospital admissions (1,328 admissions per 100,000 population) in Scotland based on the narrow measure and an estimated 88,779 smoking-attributable hospital admissions (2,656 admissions per 100,000 population) based on the broad measure (Chart 1; Table 1).
There has been a decrease in the estimated rate of smoking-attributable admissions between 2008 and 2022 (the period for which year-on-year data is available) for the narrow measure, and broad measures (34% and 23% respectively) with more evidence of variation in rates based on the broad measure.
Information presented in the remainder of this section is based on the narrow measure. See the supplementary excel tables for additional information on partially attributable hospital admissions.
The estimated rate of smoking-attributable hospital admissions in 2022 for males aged 35 and over was over 1.5 times higher than for females aged 35 and over (Chart 2; Table 1).
The estimated rate of smoking-attributable hospital admissions has fallen in all age groups since 2008, with the largest decrease in the 35-44 age group (39%) by 2022. The smallest decrease was in the 75+ age group (31%) during the same period (Char 3; Table 2).
The estimated rate of smoking–attributable hospital admissions has decreased over the time period 2008 to 2022 in each Scottish Index of Multiple Deprivation (SIMD) quintile (Chart 4, Table 3), though rates in the most deprived areas are 4.1 times higher than in the least deprived areas. While the rates have decreased over time across all quintiles, they have decreased less in the least deprived areas. As a result the estimated rate in the most deprived areas has increased from 3.3 times higher than the least deprived areas in 2008 up to 4.1 times higher in 2022. Over this time period the two least deprived quintiles have had a larger percentage decrease in their rates of admissions (Quintile 4,42%, Quintile 5, 40%) than the most deprived quintile (26%).
In 2022 the 44,573 smoking attributable admissions to hospital accounted for 29% of all admissions for conditions that can be caused by smoking (153,512 admissions) (Chart 5, Table 4). Just under half (18,642; 47%) of the admissions for cancers that can be caused by smoking, and 44.3% of respiratory conditions (13,242) that can be caused by smoking were estimated as attributable to smoking (Chart 5).
