The Impact of Smoking and Other Non-biological Factors on Sex Differences in Life Expectancy: An Analysis of 53 Developed Populations

Tobacco consumption is seen as the predominant driver of both the trend and the extent of sex differences in life expectancy. We compare the impact of smoking to the effect of other non-biological factors to assess its significance.We apply standard demographic methods for the decomposition of the sex differences in life expectancy into fractions caused by biological factors, smoking, and other non-biological factors for 53 industrialized countries and the period 1950-2009.The trend of the sex gap can indeed be attributed to smoking in most populations of the western world. However, with regard to the overall extent of male excess mortality, smoking is the main driver only in a minority of the studied populations. While the impact of smoking to the sex gap declines in all studied populations, the contribution of other non-biological factors is in most cases higher at the end than at the beginning of the observation period.Over-generalised statements which might suggest that smoking is the main force behind the sex gap in all populations could be misleading. The public health sector rather needs population-specific estimates to introduce the most appropriate measures in order to further reduce the inequalities in life years between women and men. The results of this study demonstrate that, regardless of the prevailing effect of smoking, many populations have still remarkable potentials to further narrow their sex gaps in life expectancy.