How does one reconcile an abstract knowledge that tobacco is harmful with stories of those who live to a ripe old age, despite unhealthy individual habits?
In a recent post published on the Brookings Institute’s Future Development blog, Wolfgang Fengler, a lead economist at the World Bank, and Katharina Fenz, a research assistant with World Data Lab, used Global Burden of Disease data to educate readers about “selection bias,” or the human tendency to focus on anecdotal accounts that defy the trends while ignoring the much larger body of evidence that supports them. Especially in the case of tobacco, tales of long-lived, charismatic smokers – think Winston Churchill, or Helmut Schmidt – invoke a certain kind of literary romanticism, while ignoring the very real costs and harms tobacco has on so many people’s lives.
Man smoking in India. Photo by Nithi Anand.
The post uses Global Burden of Disease data to give the costs of tobacco both a broad, measurable scope and a tangible, personalized impact, calculating the years of life the authors themselves could expect to lose from smoking given their age, gender, and the country where they live. They also compare these numbers to the average years of life lost from HIV/AIDS among the same demographics in Germany, Austria, and Kenya.
“Thanks to the Global Burden of Disease database developed by the Institute for Health Metrics and Evaluation (IHME), we can now calculate the statistical impact of health status and risks,” wrote Fengler and Fenz.
Fengler and Fenz’s comparisons highlight the importance of attending to the unique risks and disease profiles of different locations and demographics around the world. In the case of tobacco, for instance, according to a recent paper from the GBD Tobacco Collaborators, published in The Lancet, smoking trends vary widely across locations, development status, and sex. This means that we cannot take for granted that rates of smoking will continue decreasing as they have been, especially among women and in low- and middle-income countries. And unless prevention can be substantially accelerated, the study warns, “global demographic shifts are poised to heighten smoking’s global toll.”
The Global Burden of Disease study provides the data that are necessary to understand the unique and changing contours of the global tobacco burden, and to plan global policy to prevent the human cost. And as Fengler and Fenz do, hopefully we can all see ourselves reflected in those data and in the future plans to reduce the smoking burden.