Faculty of Spatial Sciences, Population Research Centre, University of Groningen, P.O. Box 800, 9700 AV, Groningen, The Netherlands.
Netherlands Interdisciplinary Demographic Institute - KNAW / University of Groningen, P.O. Box 11650, 2502 AR, The Hague, The Netherlands.
Eur J Epidemiol. 2020 Sep;35(9):835-841. doi: 10.1007/s10654-020-00602-x. Epub 2020 Jan 22.
This article provides a detailed and overarching illustration of the contribution of smoking to sex differences in life expectancy at birth (e0) in Europe, focusing on changes over time and differences between both European countries and European regions. For this purpose, the sex difference in e0 for 31 European countries over the 1950-2014 period was decomposed into a smoking- and a non-smoking-related part, using all-cause mortality data and indirectly estimated smoking-attributable mortality rates by age and sex, and a formal decomposition analysis. It was found that smoking-attributable mortality contributed, on average, 3 years (43.5%) to the 7-year life expectancy difference between women and men in 2014. This contribution, was largest in 1995, at 5.2 out of 9.0 years, and subsequently declined in parallel with the average sex difference in life expectancy. The average contribution of smoking-attributable mortality was especially large in North-Western Europe around 1975; in Southern Europe around 1985; and in Eastern Europe around 1990-1995, when smoking-attributable mortality reached maximum levels among men, but was still low among women. The observed parallel decline from 1995 onwards in the sex differences in e0 and the absolute contribution of smoking to this sex difference suggests that this recent decline in the sex difference in e0 can be almost fully explained by historical changes in sex differences in smoking, and, consequently, smoking-attributable mortality. In line with the progression of the smoking epidemic, the sex differences in life expectancy in Europe are expected to further decline in the future.
本文详细全面地阐述了吸烟对欧洲出生时预期寿命（e0）性别差异的影响，重点关注了随时间的变化以及欧洲国家和地区之间的差异。为此，使用全因死亡率数据和按年龄和性别间接估计的吸烟归因死亡率，并采用正式的分解分析方法，将 1950 年至 2014 年期间 31 个欧洲国家的 e0 性别差异分解为与吸烟和非吸烟相关的部分。结果发现，吸烟归因死亡率平均为 2014 年男女预期寿命差异的 7 年中的 3 年（43.5%）。这一贡献在 1995 年达到最大值，为 9.0 岁中的 5.2 岁，随后与平均预期寿命性别差异平行下降。吸烟归因死亡率的平均贡献在 1975 年左右的西北欧、1985 年左右的南欧以及 1990-1995 年左右的东欧尤为显著，当时男性的吸烟归因死亡率达到最高水平，而女性的吸烟归因死亡率仍然较低。自 1995 年以来，e0 的性别差异以及吸烟对这一性别差异的绝对贡献呈平行下降趋势，这表明 e0 性别差异的近期下降几乎可以完全用吸烟性别差异的历史变化来解释，因此也可以用吸烟归因死亡率来解释。随着吸烟流行的发展，欧洲的预期寿命性别差异预计将在未来进一步下降。
