Women in East Germany will be more likely to die from smoking than those in West Germany

May 10, 2017
Credit: Vera Kratochvil/public domain

Due to a silent but dramatic increase in the number of young East German women smoking after reunification, their death rates are forecasted to exceed those in the West within the next few decades according to forecasts up to the year 2036 by scientists from the Max Planck Institute for Demographic Research (MPIDR) in Rostock. The deadly trend is hidden beneath a currently favorable trend in life expectancy.

The researchers found that East German women are running the risk of an unforeseen increase in deaths through . According to the calculations, rates for deaths from lung cancer, which is a very strong indicator for the effect of smoking, will rise continuously for East German women aged 50 and older.

"In addition, all other smoking-related diseases will go up, such as atherosclerosis, angina, and heart attack," says Mikko Myrskylä, director at the Max Planck Institute for Democraphic Research.

At the same time, the researchers forecast a lasting decrease in rates of lung cancer deaths and of all deaths caused by smoking for women from West Germany, as they smoke less and less.

Currently, mortality (i.e. the risk of dying from any cause) at ages 50-69 is lower among East German women than among West German women. However, in 20 years (2036) mortality in the East is forecasted to exceed mortality in the West by almost ten percent due to smoking. This excess of ten percent solely accounts for 800 deaths per year among women aged 50-69 due to smoking

"Policies are allowing this increase of deaths in East Germany to occur", says Mikko Myrskylä. He believes that more aggressive anti-smoking policies could at least moderate the growing tobacco consumption among women in the East, which would save lives.

"Germany is more tolerant than other EU member states in its smoking policies. For example, it is the only country that allows public billboard advertising." Smoking is also socially accepted much more widely in Germany than in other EU member states, says the demographer.

Fatal trend hidden beneath life expectancy improvements

"East Germany is about to become a cautionary tale of the consequences of insufficient anti-smoking policies and the ignorance of changing behavioural norms", says Max Planck researcher Mikko Myrskylä.

Myrskylä fears that the worsening of smoking habits in the East might go unnoticed and not encourage prevention, because its effects cannot yet be seen in mortality data or . The current trend in life expectancy rather seems to be a success story for women in the East.

While mortality had been much higher in the former GDR than in West Germany, the gap narrowed rapidly after German reunification, and the low life expectancy in the East rose quickly and caught up with higher values in the West.

The convergence was particularly strong for women. Today, Eastern women aged 50-69 have a lower mortality than women in the West. But this will reverse during the coming years due to smoking, according to the new MPIDR calculations.

"It takes 15 to 25 years before increased smoking shows up in mortality," says Mikko Myrskylä. "We need to take action now to avoid unnecessary deaths in the future."

East-West crossover in smoking intensity and death rates

The projections are based on forecasted 'smoking intensity' which was computed using data from the research survey 'Socioeconomic Panel' (SOEP). Researchers calculated 'smoking intensity' as the total sum of years smoked by the age of 40.

The effects of changing smoking behaviour are most pronounced for women aged 50 to 54 and show up markedly in through lung cancer (see graphic on last page). For this age group female lung cancer death rates in the West have just reached a maximum of 32 deaths per 100,000 women while values for the East are much lower (26 deaths).

For these women, who were in their teens in between 1980 and 1984, the mean smoking intensity was still high in the West (10.6 years) but low in the East (8.8 years).

Right after reunification the tide turned. Smoking intensity for women in their teens from 1990 to 1994 is projected to climb up to 9.6 years for the East and surpass the Western value, which falls to 9.3 years. Accordingly, when these women are between 50 and 54 in 2026, lung cancer death rates in the East will have surpassed those in the West (29 and 28 deaths per 100,000 women).

The situation will have reversed completely by 2036, when lung cancer death rates of women between 50 and 54 will have fallen to a low of only 21 in the West but climbed up to 31 in the East.

Those women were teenagers around 2000-2004, when projections of smoking intensity indicate a 40-year-low of only seven years in the West but an increase up to a historical maximum of 10.6 years in the East.

Lack of good data on smoking behaviour

Part of the problem might be a lack of easily available data on in Germany that could act as an early-warning system. Data related to smoking rates by age, gender and region is seldom available in Germany and what does exist is incomplete.

Therefore, the Rostock researchers resorted to estimates on cumulative years smoked by age 40 among East and West German cohorts as measured by the German Socioeconomic Panel (SOEP), which is only accessible to scientists.

There is no single behavioural explanation for changes in this measure. If values go up it could be because more are smoking, that they took up smoking younger, or that they smoked longer (starting earlier or quitting later), or all of these reasons combined.

The scientists used counts from the mortality database of the World Health Organization (WHO), and from the Federal German Statistical Office, and from unpublished GDR archives.

Explore further: What proportion of cancer deaths are attributable to smoking around the US?

More information: Tobias Vogt, Alyson van Raalte, Pavel Grigoriev, Mikko Myrskylä, The German East-West Mortality Difference: Two Cross-Overs Driven by Smoking, Demography, DOI: 10.1007/s13524-017-0577-z

Related Stories

What proportion of cancer deaths are attributable to smoking around the US?

October 24, 2016
The proportion of cancer deaths attributable to cigarette smoking varied across the United States but was highest in the South, where nearly 40 percent of cancer deaths in men were estimated to be connected to smoking in ...

UK cancer rates to rise faster among women than men: charity

February 3, 2017
Cancer rates in Britain will rise six times faster among women than men within the next two decades, according to data released on Friday by charity Cancer Research UK.

Lung cancer now top cancer killer for women in rich nations

February 4, 2015
For the first time, lung cancer has passed breast cancer as the leading cause of cancer deaths for women in rich countries.

Estimating male fertility in eastern and western Germany since 1991

December 20, 2016
Research on men's birthrates have so far been rather a blind spot. Max Planck researchers have now calculated the missing age data for men using statistical methods. Their figures show that men on average have less children ...

Quitting smoking at any age reduces the risk of death after 70

November 30, 2016
Tobacco use continues to be a major cause of cancer and premature death. Most studies of cigarette smoking and mortality have focused on middle-aged populations, with fewer studies examining the impact of tobacco cessation ...

New study demonstrates combined impact of smoking and early menopause on mortality

August 5, 2015
Women may now have yet another reason to quit smoking given the results of a new study that is being reported online today in Menopause, the journal of The North American Menopause Society (NAMS). The Swedish study involving ...

Recommended for you

Over 50s with fewer than 20 teeth at higher risk of musculoskeletal frailty

December 11, 2017
New research by scientists at King's College London has found that tooth loss may contribute to musculoskeletal frailty in the over 50s, with those with fewer than 20 teeth being at greatest risk.

Poor sleep could lead to heavier drinking in young adults, study finds

December 8, 2017
A shortened night of sleep may increase young adults' risk of heavier drinking, according to a new Yale study that assessed reciprocal variations in sleep and drinking over time in young adults.

Researchers say nutritional labeling for sodium doesn't work

December 8, 2017
Potato chips, frozen pizza, a fast food hamburger-these foods are popular in the American diet and saturated with sodium. Though eating too much can lead to high blood pressure and heart disease, 90 percent of Americans eat ...

Observation care may save more than thought

December 8, 2017
In the world of health care spending policy, it usually works that as Medicare goes so goes private insurance on matters of managing the cost and quality of care.

Screen time before bed linked with less sleep, higher BMIs in kids

December 7, 2017
It may be tempting to let your kids stay up late playing games on their smartphones, but using digital devices before bed may contribute to sleep and nutrition problems in children, according to Penn State College of Medicine ...

Mindful yoga can reduce risky behaviors in troubled youth, says research

December 7, 2017
For some young people, dealing with life stressors like exposure to violence and family disruption often means turning to negative, risky behaviors—yet little is known about what can intervene to stop this cycle.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.