In Germany, 121,000 people die from the consequences of smoking each year. This means that smoking is implicated in 13.5 percent of all deaths. The death rate from smoking is higher in the north of Germany than in the south of the country.
These regional variations reflect variations in the smoking behavior in the German states. Across all states, more men than women die from the health consequences of smoking. Following the first report of this type in 2009, the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) now presents its second Tobacco Atlas, which again summarizes current data and facts about tobacco use, health hazards that are associated with it as well as consequences for society.
Dr. Martina Pötschke-Langer, head of DKFZ’s Cancer Prevention Unit and the WHO Collaboration Center for Tobacco Control, based at the DKFZ, declares: “The Tobacco Atlas shows that we still have to make great efforts to achieve further progress in our struggle to decrease the rate of smokers and to protect tobacco control policy from the interests of the tobacco industry.”
The Tobacco Atlas summarizes the latest data on regional and gender-specific variations in tobacco use and analyzes how these trends have changed over time. The highest death rates among smokers of both genders are found in the German city states of Bremen and Berlin, where 23 percent of men and 11 percent of women die from the consequences of smoking. The smoking-related death rates among men are lowest in the states of Baden-Württemberg and Bavaria (17 and 18 percent); for women in Saxony and Thuringia (4 and 5 percent).
While the smoking behavior in the age group between 25 and 69 years has remained largely stable since 2009, smoking rates among young adults and minors have been dropping continuously. At the same time, electronic inhalation products such as e-cigarettes and e-shishas have emerged on the market and created new consumer trends. They have become particularly popular among youth: About one third of young people between 12 and 17 years of age has smoked shisha at least once and one quarter of youth in this age group has tried e-cigarettes.
The cigarette has always been and continues to be a toxic mixture and its consumption entails severe hazards to health. Illnesses caused by smoking include, above all, cancer, cardiovascular and respiratory diseases. Cancer accounts for 52 percent of smoking-related deaths in men, and 41 percent in women. In recent years, the list of tobacco-related diseases has been extended by type 2 diabetes, erectile dysfunction, age-related macular degeneration as well as tuberculosis and further types of cancer such as liver cancer and bowel cancer. Nicotine, which is contained in tobacco and electronic inhalation products, is addictive and, as recent research results have shown, anything but a harmless substance. Nicotine is toxic and suspected to promote chronic diseases such as arteriosclerosis as well as the development and progression of cancer and – if consumed during pregnancy – to cause long-term and lasting impairment to the lung and brain development in the unborn child.
Besides causing harm to people’s health, smoking also causes a high financial burden for society at large. In Germany, the societal cost of smoking is about € 80 billion each year. Of these, approximately one third is health care costs (direct costs) and two thirds are economic costs due to productivity loss and early retirement (indirect costs).
The German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ) publishes this new edition of the Tobacco Atlas in order to present the latest scientific facts and figures to the public and the media as well as to urge political decision-makers to take action based on the information outlined. In 2005, the World Health Organization created the Framework Convention on Tobacco Control (WHO FCTC), which is legally binding also for Germany. Nevertheless, Germany has failed to or only inadequately implemented a number of measures foreseen therein, in particular, regular considerable increases in the tax on tobacco and a comprehensive advertising ban.
The shortfalls in Germany’s tobacco control policy also become obvious in comparison with other European countries. Since 2007, when Germany first introduced non-smoker protection legislation at the federal level – and, soon after, also in the German states –, the country has not taken any substantial new tobacco control measures. Not only has it failed to raise tobacco tax considerably and regularly, it also has not enacted a comprehensive ban on tobacco advertising (Germany and Bulgaria are the only countries in Europe where large-sized tobacco advertising on billboards and advertising pillars is still allowed). In addition, non-smoker protection in catering establishments continues to be patchy and with many exceptions. For this reason, Germany was ranked second to last in a ranking of tobacco control policy of the European countries in 2013.