International comparisons of preventable risk factors

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

Indicator

Last updated: 26/02/2020

Effective clinical care
Primary and community care Public health International

Background

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 tobacco smoking, obesity and alcohol consumption internationally over time.


How does the proportion of adult smokers compare internationally over time? 26/02/2020

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Tobacco smoking is a risk factor for cancer, stroke, coronary heart disease, respiratory diseases such as chronic obstructive pulmonary disease (COPD), and smoking while pregnant can lead to low birth weight and illnesses among infants. The World Health Organisation (WHO) has estimated that tobacco smoking kills more than 8 million people each year worldwide, of which around 1.2 million deaths are the result of second-hand smoke.

Daily smoking has decreased in most OECD countries since 2000. In the Great Britain, the proportion of the population aged 15+ who are daily smokers decreased from 27% in 2000 to 16% in 2016 (a decrease of 11%), but then increased to 17% in 2017. Between 2000 and 2017, the largest decreases among the comparator countries were in the Netherlands (a decrease of 15%) and Denmark (a decrease of 14%). In 2017, Spain had the highest rate of tobacco smoking, with 22% of the country’s adult population classified as daily smokers. Sweden had the lowest proportion of adults who were daily smokers at 10%.


How does the prevalence of obesity compare internationally over time? 26/02/2020

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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. In England, the proportion of the total population who are obese increased from 21% in 2000 to 29% in 2017. Japan consistently has very low rates of obesity, however the proportion has still risen over the same time period, from 2.9% to 4.4%. Among the comparator countries, the United States has the highest proportion of the total population who are obese, at 40% in 2016.

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? 26/02/2020

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Harmful alcohol use is a leading cause of death and disability worldwide, particularly in adults of working age. Globally, 3 million deaths result from harmful alcohol use each year, representing 5.3% 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 of pure alcohol per capita per year, to 8.9 litres per capita per year in 2017. 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, but then increased to 9.7 litres per capita in 2017. In 2017, alcohol consumption in the UK was just above the average of the comparator countries. Sweden had the lowest alcohol consumption at 7.1 litres per capita, and France had the highest at 11.7 litres per capita.

There are already many policies that 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 2019: 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. 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 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. 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 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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