Age- and sex-specific smoking trends by birth cohort in Norway, 1978-2024: an analysis of cross-sectional survey data
In brief
About two-thirds of Norway's 1950-born adults had smoked daily
Survey data from 78,282 people suggest daily smoking peaked in the 1950 birth cohort, reaching 70% of men and 66% of women, while later generations were less likely to start, more likely to quit and smoked fewer cigarettes per day. These modeled trends can inform lung cancer prevention planning, but do not directly measure future disease or screening outcomes.
- Journal
- The Lancet regional health. Europe (Q1)
- Published
- 15 October 2026
- Study design
- Cross-sectional study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Jacopo Di Silvestre, M Victoria Salgado, Jihyoun Jeon, Yoonseo Mok, Theodore R Holford, Tord Finne Vedøy, et al.
- PMID
- 42926883
- DOI
- 10.1016/j.lanepe.2026.101886
Why clinicians should know about it
- Picked for Epidemiology (paper of the day, 29 October 2026): National surveys model smoking trends across age and birth cohorts
Abstract
BACKGROUND: Smoking is the primary cause of lung cancer, the leading cause of cancer-related mortality in Norway. To inform disease modeling and tobacco control policies, including lung cancer screening, we estimated sex-specific, birth-cohort smoking behaviors among Norwegians born between 1950 and 2000 using national survey data. METHODS: We analyzed nationally representative cross-sectional survey data from 1978 to 2024 (n = 78,282) to reconstruct smoking trends and smoking intensity in Norway. We used a previously established Age-Period-Cohort modeling framework to estimate cohort-specific prevalence of daily ever-smoking, probabilities of smoking initiation and cessation, prevalence of daily current-smoking, and average cigarettes smoked per day (CPD). Analyses were conducted separately by sex assigned at birth for cohorts born between 1950 and 2000. FINDINGS: Daily ever-smoking prevalence peaked in the 1950 birth cohort, reaching 70% (90% CI 66%-91%) among males and 66% (90% CI 55%-89%) among females, alongside similar peaks in smoking initiation probabilities, 13% (90% CI 12%-24%) for males and 12% (90% CI 10%-23%) for females. Smoking cessation probabilities increased with age within each birth cohort, rising from approximately 0% to 5% over 40 years in earlier cohorts, compared with an increase from about 5% to 15% over 20 years from the 1965 birth cohort onward. Smoking intensity peaked at 15 CPD among males and 12 CPD among females. Although smoking intensity declined in both sexes after the 1975 birth cohort, it remained higher among males, with peak model-estimated CPD decreasing from approximately 13.5 to 10 cigarettes in males and from 11.5 to 7.5 cigarettes in females between the 1980 and 2000 birth cohorts. INTERPRETATION: Smoking behavior in Norway has changed across generations, with declining smoking initiation rates, increased smoking cessation, and lower cigarettes per day. Understanding these trends provides essential inputs to inform tobacco control and lung cancer prevention policies in Norway. FUNDING: Norwegian Cancer Society, National Cancer Institute of the National Institutes of Health, U.S. Food and Drug Administration.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.