International comparisons of preventable risk factors

We evaluate how rates of smoking, obesity and alcohol consumption compare internationally.

Qualitywatch

Indicator

Last updated: 31/10/2024

Background

Preventable risk factors such as smoking tobacco, being overweight, physical inactivity and harmful use of alcohol contribute to the global burden of non-communicable diseases. These risk factors can be influenced by effective policies (e.g. the smoking ban) and public health campaigns. Here we compare the prevalence of tobacco smoking, obesity and alcohol consumption internationally over time.


Adult smokers by country

Smoking tobacco is a risk factor for cancer, stroke, coronary heart disease and respiratory diseases such as chronic obstructive pulmonary disease (COPD). Smoking while pregnant can lead to low birth weight and illnesses among infants. The World Health Organization (WHO) has estimated that tobacco smoking kills more than 8 million people each year worldwide, of which around 1.3 million deaths are the result of second-hand smoke.

Daily smoking has decreased in most OECD countries since 2006. In the UK, the proportion of the population aged 15+ who are daily smokers decreased from 22% in 2006 to 11% in 2022. Between 2006 and 2019, the largest decreases among the comparator countries were in Greece (from 40% to 25%) and The Netherlands (from 25% to 15%, decreasing further to 13% in 2022). In 2021, France had the highest rate of tobacco smoking out of the countries for which there was data, with 25% of the country’s adult population classified as daily smokers. In 2022, Canada, Sweden and the United States had the lowest proportion of daily smokers, ranging between 9–10%.

Many OECD countries have introduced policies to reduce tobacco use, such as raising taxes on tobacco products, banning advertising and providing support for smokers to quit.


Obesity by country

Obesity has been rising in most OECD countries over the past two decades. In the United Kingdom, this trend accelerated during the Covid-19 pandemic: in the 2021/22 school year, over 23% of Year 6 children were either obese or severely obese. Further, the prevalence of obesity in the UK for those aged 15 and over increased from 21% in 2000 to 28% in 2019. Japan has consistently had very low rates of obesity; however, the proportion has still risen over the same period, from 3% to 5%. Among the comparator countries, the United States has the highest proportion of the total population who are obese, at 43% in 2019. It is important to note that only 1 of the 12 countries shown in the graph have available data for 2020 and 2021 and 2 of the 12 countries for 2022, limiting the ability to make international comparisons for the more recent years.

Over 90% of OECD countries have drawn up action plans to combat unhealthy diets and physical inactivity. These include food labelling measures, using social media and new technologies for public health promotion, and taxation policies to raise the price of foods that are high in salt, fat or sugar.


Alcohol consumption by country

Recorded alcohol consumption has decreased in many OECD countries since 2000. However, the extent of the decrease varies by country, and consumption has in fact increased in 3 of the 19 countries included here (Canada, Sweden and the United States). Between 2000 and 2010, annual alcohol consumption in the United Kingdom was 10.8 litres per capita on average. Over the next ten years, average consumption decreased to 9.90 litres per capita in 2022 but was higher than the average of the comparator countries (9.3 litres). In the same year, Japan had the lowest alcohol consumption at 6.8 litres per capita, and Austria had the highest at 11.6 litres per capita.

All OECD countries apply taxes to alcoholic beverages, but the level of tax varies across countries. New forms of policy are being implemented, such as minimum unit pricing of alcohol which sets a price floor beneath which alcohol cannot be sold, and mandatory cautionary labelling on alcohol products. Other commonly used policies are legal limits for driving under the influence of alcohol and controls on drinking age and hours of sale.


About this data

Definitions and comparability for the indicators are taken directly from the OECD report Health at a Glance 2023: OECD Indicators. Detailed information about the definitions and the source and methods for each country can be found here.

Tobacco consumption:
The proportion of daily smokers is defined as the percentage of the population aged 15 years and over who report smoking tobacco every day. Other forms of smokeless tobacco products, such as snuff in Sweden, are not considered. This indicator is more representative of the smoking population than the average number of cigarettes smoked per day, as the act of smoking is more determining of regular smoking than the quantity. Most countries report data for the population aged 15+, but there are some exceptions. International comparability may be affected by a lack of standardisation in the measurement of smoking habits in health interview surveys across OECD countries.

Obese population:
Overweight and obesity are defined as excessive weight presenting health risks because of the high proportion of body fat. The most frequently used measure is based on the body mass index (BMI), which is a single number that evaluates an individual's weight in relation to height (weight/height², with weight in kilograms and height in metres). Based on the WHO classification, adults over the age of 18 with a BMI greater than or equal to 25 are defined as overweight, and those with a BMI greater than or equal to 30 as obese. Most countries report data for the population aged 15+, but there are some exceptions. Rates of overweight and obesity can be assessed through self-reported estimates of height and weight derived from population-based health interview surveys, or measured estimates derived from health examinations (which we have used here). Estimates from health examinations are generally higher and more reliable than those from health interviews.

Alcohol consumption:
Recorded alcohol consumption is defined as annual sales of pure alcohol in litres per person aged 15 years and over. Most countries report data for the population aged 15+, but there are some exceptions. The methodology to convert alcoholic drinks to pure alcohol may differ across countries. Official statistics do not include unrecorded alcohol consumption, such as home production. In some countries, national sales do not accurately reflect actual consumption by residents, since purchases by non-residents may create a significant gap between national sales and consumption.

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