Smoking – facts and figures

Smoking is the most common preventable cause of death in developed countries. This fact has been known for a long time – yet many people still smoke. How does this fit together? After all, millions of people have quit smoking in recent years. How has the percentage of smokers in the population evolved in recent years?

Smoking-related deaths

Source: © Leonid Nyshko –

121.000 people in Germany died as a result of smoking in 2013. Thus, 13.5 percent of all deaths were due to smoking. The significantly higher figure compared to previous calculations (Tabakatlas 2009: 107.000 tobacco-related deaths) is due to the fact that, for the first time, deaths due to colorectal and liver cancer, type 2 diabetes and tuberculosis as well as cardiovascular diseases were also taken into account.

Smoking is the main risk factor for lung cancer. Four out of five lung cancer deaths are due to smoking. In men, lung cancer has been the leading cause of cancer death since the 1960s. In women, on the other hand, the mortality rate due to lung cancer has increased significantly only in recent years, as smoking spread much later among women than among men. It is estimated that more and more women will die of lung cancer in the coming years, so that lung cancer will replace breast cancer in women and become the leading cause of death among them as well.

Who smokes and how much?

The number of smokers in Germany continues to decline – especially among young people. At the end of the 1990s, just under 30 percent of 12- to 17-year-olds smoked; today, the figure is only about 10 percent. The proportion of smokers was and is highest among young adults: Among 18- to 25-year-olds, about one in two smoked in the late 1990s; today, only nearly one in three smokes. Nevertheless, among young adults, the proportion of smokers is highest: of those aged 25 to 29, one-third smoked in 2015. Among 11- to 17-year-old children and adolescents, a total of 12 percent smoke, with no differences between the sexes.

About 31 percent of smokers smoke only occasionally; about 24 percent smoke up to 10 cigarettes a day; about 23 percent smoke 11 to 19 cigarettes a day; and 21 percent smoke heavily, meaning 20 cigarettes a day or more. Young people are even mostly occasional smokers, while regular and heavy smoking predominates among older people. In 2015, only 9 percent of 18- to 20-year-olds smoked 20 cigarettes a day, compared to 59 percent of women smokers. Among smokers over 40, a quarter of all smokers smoked at least 20 cigarettes. With increasing age, the proportion of daily smokers rises for both sexes. Among men, the proportion of smokers with high use increases with age to a greater extent than among women.

In addition, the proportion of smokers is greater in the north than in southern Germany. Depending on the state, 27 to 35 percent of men and 17 to 24 percent of women smoke.

Smoking behavior also differs by social status, which is measured by education level, occupational status and income situation. For several decades already, more men and women with low social status smoke than those with high social status.

Source: Infographic (BZgA) 2018; Data source: short report Epidemiological Survey on Addiction 2015

Smoking among young people: The trend is toward e-inhalation products

The proportion of adolescent smokers, which has been falling for years, has continued to decline and is currently only 10 percent. However, this decline is mainly due to the fact that young people in Germany hardly ever smoke cigarettes anymore.

However, the statistics only cover classic tobacco products such as cigarettes. The trend among young people between the ages of 12 and 17 is toward oriental water pipes, so-called shishas, and electronic inhalation products such as e-cigarettes and e-shishas. In 2016, nine percent of Germans over 16 have tried e-cigarettes at least once or are current users. Smokers and teens and young adults are particularly interested in the products: 17 percent of 16- to 19-year-olds and 14 percent of 20- to 29-year-olds have already used e-cigarettes.

The aerosol from e-inhalation products, which is inhaled by the consumer up to several hundred times a day, contains substances that are harmful to health. A recently published study by the American Academy of Sciences showed for the first time that e-cigarettes, which were previously marketed as not harmful to health, can also cause cancer. The damage is not found in the blood, as previously assumed, but directly in the cells – and is therefore involved in the development of DNA changes and mutations, just like conventional cigarettes. This effect is caused by nicotine, which is still present in high concentrations in e-cigarettes. Due to the possible health risks and addiction potential, e-inhalation products are completely unsuitable for non-smokers, children, adolescents, pregnant women and people with damaged lungs or cardiovascular diseases. For smokers, it can be assumed that e-cigarettes are less harmful than cigarettes – but only if the smoker completely gives up tobacco cigarettes. And the opposite seems to be true: Scientists concluded that young people often turn first to e-cigarettes, and then, as a result, to traditional tobacco products.

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