[Impact of tobacco, alcohol overconsumption and drug abuse on mortality in Denmark. Trends over 25 years, 1973-1997].
BACKGROUND
The aim of the study was to estimate the national impact of smoking, alcohol, and drugs on mortality.


METHODS
The analysis was based on the cause of death register. Deaths attributable to smoking were calculated by an indirect method. Deaths related to alcohol and drugs (illegal drugs and prescription drugs) were defined by the underlying and contributory causes of death.


RESULTS
In the period, 1993-1997, 30% of all deaths in men and 20% in women were related to tobacco, alcohol, or drugs. The percentages of all deaths for tobacco, alcohol, and drugs were respectively 22.8%, 6.3%, and 1.2% for men and 16.5%, 2.5%, and 0.7% for women. Every year 12,000 Danes die 11-13 years prematurely, because of tobacco, more than 2500 die more than 20 years prematurely, because of alcohol, and about 600 die almost 30 years prematurely, because of drugs. The standardised lifetime risk of death from one of these three causes was about 30% for men, highest in the middle five-year period. For women--because of substantially increased mortality attributable to smoking--there was a large increase from 8% to 20%. In the municipality of Copenhagen, the lifetime risk for men was about 50%, for women it increased from 15% in the middle of the 1970s to more than 30% in the middle of the 1990s. For both men and women, mortality in the age group 35-74 declined sharply, when mortality related to the three causes was excluded. However, the heavy increase in smoking-related deaths in women means that the total mortality over the entire period has been almost constant.


CONCLUSIONS
It is a tremendous challenge to change the impact of tobacco, alcohol, and drugs on mortality in Denmark.
Juel
K
K
Statens Institut for Folkesundhed, København. kj@dike.dk
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000401:mortality* / Q000639:trends; D002423:Cause of Death / Q000639:trends; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality* / Q000639:trends; D019966:Substance-Related Disorders / Q000150:complications / Q000401:mortality*
Betydning af tobak, stort alkoholforbrug og stofmisbrug på dødeligheden i Danmark. Udviklingen gennem 25 år, 1973-1997.