Why did Danish women’s life expectancy stagnate? The influence of interwar generations’ smoking behaviour

Abstract

The general health status of a population changes over time, generally in a positive direction. Some generations experience more unfavourable conditions than others. The health of Danish women in the interwar generations is an example of such a phenomenon. The stagnation in their life expectancy between 1977 and 1995 is thought to be related to their smoking behaviour. So far, no study has measured the absolute effect of smoking on the mortality of the interwar generations of Danish women and thus the stagnation in Danish women's life expectancy. We applied a method to estimate age-specific smoking-attributable number of deaths to examine the effect of smoking on the trends in partial life expectancy of Danish women between age 50 and 85 from 1950 to 2012. We compared these trends to those for women in Sweden, where there was no similar stagnation in life expectancy. When smoking-attributable mortality was excluded, the gap in partial life expectancy at age 50 between Swedish and Danish women diminished substantially. The effect was most pronounced in the interwar generations. The major reason for the stagnation in Danish women's partial life expectancy at age 50 was found to be smoking-related mortality in the interwar generations.

An age-at-death distribution approach to forecast cohort mortality

“…Such results are consistent with other findings in the literature (see, e.g., Fig. 4 in Jacobsen et al, 2002), which have been attributed to the smoking behaviour of Danish women (Jacobsen et al, 2006;Lindahl-Jacobsen et al, 2016).…”

Progression of the smoking epidemic in high-income regions and its effects on male-female survival differences: a cohort-by-age analysis of 17 countries.

“…The massive impact of smoking on mortality is in line with previous studies addressing smoking effects on mortality at the population level; it has been found for the United States [14], in European countries [12,15,[30][31][32][33][34][35], and worldwide [36]. Smoking affects various causes of death, such as various forms of cancer, cardiovascular disease and multifarious diseases of the respiratory tract [37,38].…”

Endgame of the smoking epidemic in high-income countries reflected in life expectancy sex differences: a populations-based study

“…Our results are in line with previous studies addressing smoking effects on the population level. The huge impact of smoking on survival has been found for the US [27] in European countries [11,[28][29][30][31][32][33][34] and worldwide [35]. Smoking affects various causes of death, such as various forms of cancer, cardiovascular disease and multifarious diseases of the respiratory tract [36,37].…”

“…It has been shown that the detrimental effects of smoking take place across cohorts [11]. Where previous research has mostly focused on the period patterns of the smoking epidemic, in this article we aim to assess whether the smoking epidemic in high income countries is ending by examining changes in smoking-attributable mortality fractions between birth cohorts as well as changes in the role of smoking in life expectancy sex differences.…”