It’s well known that Europeans like to smoke. A recent European Commission survey (PDF) showed that 28% of Europeans light up, while this week’s MMWR from the CDC indicates that 19% of Americans smoke. Therefore, one would predict that more Europeans die from smoking than Americans. But, you would be wrong.

In the EU, about 695,000 people die annually from what the EC report calls “tobacco related causes.” (The report also examined tobacco products other than cigarettes.) Roughly 503 million people live in the EU, meaning that the mortality rate due to tobacco is 138 deaths per 100,000 people.

In the U.S., about 443,000 people die from what the CDC report calls “smoking related illnesses.” (The report focused exclusively on cigarettes.) But, the population of the U.S. is much lower than the EU, about 315 million people. That means the mortality rate due to smoking is 141 deaths per 100,000 people. That’s 3 more deaths per 100,000 people than Europe despite the fact that more Europeans smoke! What is going on?

Since these were two different reports, it is possible that differences in methodology account for the disparity. But, by digging deeper into the numbers, one can spot a more likely explanation.

The chart below shows the percentage of American smokers by the number of cigarettes smoked per day

As shown, in the U.S., approximately
22% of smokers smoked 1 9 cigarettes per day (CPD)
37% smoked 10 19 CPD
31% smoked 20 29 CPD
9% smoked 30 or more CPD
(Percents don’t add up to 100% due to approximate readings from the chart.)

Compare that to European smokers. (The outer ring represents data for 2012.)

In Europe
43% smoked 1 10 CPD
46% smoked 11 20 CPD
9% smoked 21 or more CPD
(Percents don’t add up to 100% because about 2% of smokers smoked less than 1 CPD.)

Combining all that data, we see that far more American smokers (40%) than European smokers (9%) smoked 20 or more cigarettes per day. Overall, in the U.S., the average number of cigarettes smoked per day is 15.1, but in the EU it is 14.2.

The data seems to show that even though more Europeans smoke than Americans, American smokers are much heavier smokers. Could this be why more Americans die from smoking related diseases?

Source Centers for Disease Control and Prevention. “Current Cigarette Smoking Among Adults United States, 2011.” MMWR 61 (44) 889 894.

Source European Commission. “Attitudes of Europeans Towards Tobacco.” Special Eurobarometer 385 (May 2012).

E-cigarettes under scrutiny as eu prepares to vote – channel 4 news

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The vote comes after months of wrangling from pro tobacco lobbyists and health campaigners. But MEPs will finally have their say on a range of tobacco products on Tuesday, with the expected aim of discouraging smoking throughout the EU.

They are set to impose bigger and bolder warnings on cigarette packs, a ban on flavourings like menthol and putting electronic cigarettes under tighter regulation.

E cigarettes have become one of the most popular devices among those trying to give up smoking. But some health experts say that they undermine anti smoking campaigns, while a study in a leading Canadian medical journal found that they run the risk of getting a new generation hooked on nicotine.

In light of the differing views, we have decided to wait until the emerging impact of the decision in Australia can be measured. Anna Soubry

Under EU proposals, the e cigarettes would become a medicinal product and the health warnings in text and pictures on cigarette packs sold in the EU would be bigger and bolder. Ten packs of cigarettes and slim cigarettes would also be banned.

The package of proposals, which was at the heart of the resignation of John Dalli as a European commissioner amid cash for influence allegations, has reportedly attracted an army of lobbyists for the multi billion pound industry to Strasbourg.

The vote was initially scheduled for last month but was delayed after accusations of pressure from the pro tobacco lobby.

UK position

If a majority of lawmakers back the legislation, the European parliament must still reach a compromise with EU governments on certain points before the rules can come into force, possibly next year.

Public Health Minister Anna Soubry said “Smoking is one of the biggest and most stubborn challenges in public health. The UK government supports the proposed Europe wide controls that would introduce a ban on flavoured cigarettes and strict rules on front of pack health warnings.”

In Australia, cigarettes must be sold in plain olive green packets with graphic health warnings, and Ms Soubry said the UK would judge the impact it has had there.

“We take very seriously the potential for standardised packaging to reduce smoking rates but, in light of the differing views, we have decided to wait until the emerging impact of the decision in Australia can be measured, and then we will make a decision in England,” she added.

The treatment of smoke related diseases costs around 25bn euros a year, and the EU estimates that there are around 700,000 smoking related deaths annually across the 28 nation bloc.