International comparisons of preventable risk factors

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


Last updated: 31/07/2018

Effective clinical care
Primary and community care Public health International

Preventable risk factors such as tobacco smoking, 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 obesity, tobacco smoking and alcohol consumption internationally over time.

How does the proportion of adult smokers compare internationally over time? 30/07/2018

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Tobacco smoking is a risk factor for cancer, stroke, coronary heart disease, respiratory diseases such as COPD, and smoking while pregnant can lead to low birth weight and illnesses among infants. The WHO has estimated that tobacco smoking kills more than 7 million people each year worldwide, of which around 890,000 are the result of second-hand smoke.

Daily smoking has decreased in most OECD countries since 2000. In the UK, the proportion of the population aged 15+ who are daily smokers decreased from 27% in 2000 to 16.1% in 2016 (a decrease of 10.9%). This is the third largest decrease of the comparator countries, after Denmark (a decrease of 13.6%) and New Zealand (a decrease of 11.2%). Greece consistently has the highest level of tobacco smoking, with 40% of their adult population classified as daily smokers between 2006 and 2008. In 2016, Sweden had the lowest proportion of adults who were daily smokers at 10.9%

How does the prevalence of obesity compare internationally over time? 30/07/2018

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Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases, and cancer. Globally, there were more than 1.9 billion adults aged 18 years and older who were overweight in 2016, and of these over 650 million were obese.

Obesity has been rising in most OECD countries over the past two decades, and projections show that this trend will continue. In the UK, the proportion of the total population who are obese increased from 21.2% in 2000 to 26.2% in 2016. Japan consistently has very low levels of obesity, however even there the proportion has risen from 2.9% to 4.2%. In 2016, 40% of the total population in the United States were obese.

OECD countries have implemented a range of public health policies in recent years to try to slow the obesity epidemic. 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.

How does the UK's alcohol consumption compare internationally over time? 30/07/2018

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Harmful alcohol use is a leading cause of death and disability worldwide, particularly in adults of working age. Globally, 3.3 million deaths result from harmful alcohol use each year, representing 5.9% of all deaths. There is a causal relationship between harmful use of alcohol and a range of mental and behavioural disorders, non-communicable diseases and injuries.

On average, recorded alcohol consumption has decreased in all OECD countries since 2000, from 9.5 litres per capita per year to 9 litres of pure alcohol per capita per year (equivalent to 96 bottles of wine). 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). In the UK, alcohol consumption decreased from 10.4 litres per capita in 2000 to 9.5 litres per capita in 2016. In 2016, alcohol consumption in the UK was just above the average of the comparator countries. Greece had the lowest alcohol consumption at 6.5 litres per capita, and France had the highest at 11.7 litres per capita.

There are already many policies which target harmful use of alcohol: some target heavy drinkers, while others cover whole populations. All OECD countries apply taxes to alcoholic beverages, but the level of tax varies across countries. New forms of fiscal policies are being implemented such as minimum pricing of one unit of alcohol in Scotland. Regulations on advertising alcoholic products have been set up, and all OECD countries have set legal limits for driving under the influence of alcohol. Countries have also implemented health promotion campaigns, school-based and workplace interventions, and interventions in primary care.

About this data

Definitions and comparability for the indicators are taken directly from the OECD report Health at a Glance 2017: 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 tobacco smoking every day. Other forms of smokeless tobacco products, such as snuff in Sweden, are not taken into account. 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 than the quantity. Most countries report data for the population ages 15+, but there are some exceptions.

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 age 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. Overweight and obesity rates 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 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 alcohol 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.