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EDITOR Our calculation is for men only and based on the difference in life
expectancy between male smokers and non-smokers and an estimate of the
total number of cigarettes a regular male smoker might consume in his
lifetime. We derived the difference in life expectancy for smokers and
non-smokers by using mortality ratios from the study of Doll et al of
34 000 male doctors over 40 years.1 The relative death
rates of smokers compared with non-smokers were threefold for men aged
45-64 and twofold for those aged 65-84,1 as corroborated
elsewhere.2 Average life expectancy from birth for the
whole population or subgroups can be derived from life tables. Applying
the rates of Doll et al to the latest interim life tables for men in
England and Wales, with adjustment for the proportion of smokers and
non-smokers in each five year age group,3 we found a
difference in life expectancy between smokers and non-smokers of 6.5 years.
We used the proportion of smokers by age group, the median age of
starting smoking, and the average number of cigarettes smoked per week
in the 1996 general household survey.4 We calculated that
if a man smokes the average number of cigarettes a year (5772) from the
median starting age of 17 until his death at the age of 71 he will
consume a total of 311 688 cigarettes in his lifetime.
If we then assume that each cigarette makes the same contribution to
his death, each cigarette has cost him, on average, 11 minutes of life:
6.5 years=2374 days, 56 976 hours, or 3 418 560 minutes
5772 cigarettes per year for 54 years=311 688 cigarettes
3 418 560/311 688=11 minutes per cigarette.
This calculation is admittedly crude The first day of the year is traditionally a time when many smokers try
to stop, and on 1 January 2000 a record number might be expected to try
to start the new millennium more healthily. The fact that each
cigarette they smoke reduces their life by 11 minutes may spur them on.
The table shows some better uses for the time they
save.
Studies investigating the impact on mortality of socioeconomic
and lifestyle factors such as smoking tend to report death rates, death
rate ratios, odds ratios, or the chances of smokers reaching different
ages. These findings may also be converted into differences in life
expectancy. We estimated how much life is lost in smoking one cigarette.
it relies on averages, assumes
that the health effects of smoking are evenly spread throughout a
smoker's lifetime, presupposes that the number of cigarettes smoked
throughout a lifetime is constant, and ignores the difficulties in
classifying people as either lifetime smokers or
non-smokers.5 However, it shows the high cost of smoking
in a way that everyone can understand.
Richard Mitchell
Danny Dorling
School of Geographical Sciences, University of Bristol,
Bristol BS8 1SS
Competing interests: Drs Shaw and Mitchell are non-smokers. Dr Dorling is a smoker (20 cigarettes a day).
| 1. |
Doll R, Peto R, Wheatley K, Gray R, Sutherland I.
Mortality in relation to smoking: 40 years' observations on male British doctors.
BMJ
1994;
309:
901-911 |
| 2. |
Phillips AN, Wannamethee SG, Walker M, Thomson A, Davey Smith G.
Life expectancy in men who have never smoked and those who have smoked continuously: 15 year follow up of large cohort of middle aged British men.
BMJ
1996;
313:
907-908 |
| 3. | Office for National Statistics. 1997 mortality statistics: general. London: Stationery Office, 1999(Series DH1 No 30.) |
| 4. | Office for National Statistics. General household survey. Living in Britain. London: Stationery Office, 1996. |
| 5. |
Suidicani P, Hein HO, Gyntelberg F.
Mortality and morbidity of potentially misclassified smokers.
Int J Epidemiol
1997;
26:
321-327 |
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