Hungarian trends and gender differences in the global smoking epidemic

This paper analyzes whether developments in Hungary are in keeping with the trends of the process known as the “global smoking epidemic.” To this end, the comparative cases of the USA and Austria are used as a benchmark for reviewing the results concerning tobacco consumption and sex differences in mortality. A comparative analysis has been conducted using prevalence and tobacco-related mortality data in longer-term perspectives. The study analyzes the descriptive statistics of the smoking-attributable premature mortality trends in Hungary between 2000 and 2015 by sex, age, and cause of death, using the updated method of the American Centers for Disease Control and Prevention. The results show that Hungarian men are suffering more destructive consequences of the smoking epidemic than American or Austrian men. Hungarian and Austrian women are half a century behind the peak of the epidemic in the USA, and the harmful effect is also smaller than in the USA. Nevertheless, we can also predict that differences by sex will decrease significantly in the future. Between 2000 and 2015, male smoking-attributable mortality declined in Hungary; meanwhile, among women it increased dramatically. As a consequence, in the over-50 age group, increasing tobacco-related mortality is holding back the improvement in female mortality. The key causes of death attributable to smoking – e.g., bronchitis, emphysema, and COPD, and lung, bronchus, and trachea cancers – are also identified. All this means that, in every age group and for almost all causes of death, the differences by sex declined significantly in the period analyzed. Our results indicate that compared to the United States, the possibly more traditional gender roles characterizing Austrian and Hungarian society, and the related cultural norms, reduced the harm arising from the cigarette epidemic among Central and Eastern European women. However, a strong negative cohort effect can also be identified in the Hungarian female population born between 1945 and 1965, largely due to smoking. This implies that the promotion of a healthy life style among middle-aged and older females could be a major policy target.