Smoking overtaken as No 1 contributor to disease burden

4 minute read


Overweight and obesity are now the greatest risk factor.


The Australian Institute for Health and Welfare released the Australian Burden of Disease Study 2024 earlier today, with overweight and obesity overtaking tobacco smoking as the risk factor with the largest contribution to disease burden.

The study estimated that 8.3% of total disease burden for the 2024 calendar year was due to overweight and obesity, ahead of tobacco use (excluding vaping; 7.6%), dietary risks (4.8%) and high blood pressure (4.4%).

There has been a significant decrease in disease burden associated with tobacco use over the past two decades, with the age-standardised rate of the total burden attributable to this particular risk factor falling by 41% since 2003.

“This fall is likely due to declines in smoking prevalence and burden rates from some of the major linked diseases, such as lung cancer and chronic obstructive pulmonary disease (COPD),” said AIWH spokesperson Michelle Gourley.

Almost six million years of healthy life had been unnecessarily lost this year due to living with disease and/or premature death, according to the study.

“Over one-third of the total burden of disease and injury in Australia in 2024 could have been avoided or reduced due to modifiable risk factors included in the study,” Ms Gourley said.

“Burden of disease is the gold standard approach for measuring the impact of illness, injury and death, and this information provides an important evidence base to inform health policy and service planning.”

Public Health Association of Australia CEO Adjunct Professor Terry Slevin stressed the need for ongoing vigilance against the growing impact of overweight and obesity.

“Reducing the marketing of unhealthy food; sensible, honest, understandable food labelling; introducing a health levy on high energy sugary drinks and funding programs that will help drive down rates of overweight and obesity are all sensible, achievable strategies,” he said.

“We have to make it easier for people to be healthier. Action on obesity is the next vital cab off the rank when it comes to improving the health of people in Australia and shifting these disease burden metrics in the future.”

The age-adjusted rate of total disease burden has decreased by 10% between 2003 and 2024, thanks to a 26% decrease in the rate of fatal disease burden. However, this improvement was offset somewhat by a 7% increase in the rate of non-fatal disease burden.

“While Australians are living longer on average, years lived in ill health are also growing, resulting in little change in the proportion of life spent in full health. This contributes to the growing demand and pressures on the health system and services,” said Ms Gourley.

Australia isn’t the only country where the gap between the number of years lived in good health and our total lifespan is increasing – but we are one of the worst performers on this metric, according to new research published in JAMA Network Open.

A review of healthspan-lifespan gaps in the 183 World Health Organization member states over the past two decades reports that the gap is 12.1 years for Australia and 11.8 years for New Zealand, behind only the United States (12.4 years).

“These results underscore that around the world, while people live longer, they live a greater number of years burdened by disease,” the authors concluded.

“These findings suggest that the healthspan-lifespan gap is a universal threat to healthy longevity.”

The AIHW also released a new interactive dashboard designed to monitor progress on the National Preventive Health Strategy 2021-2030 and the National Obesity Strategy 2022-2032.

The pair of strategies provide a range of targets relating to different preventative health measures, such as reducing tobacco use and alcohol consumption whole improving healthy eating and physical activity.

Data presented in the dashboard shows similar findings to the burden of disease study – a decrease in the proportion of adults who report smoking on a daily basis (down from 13.8% in 2017-18 to 10.6% in 2022) but an increase in the proportion of Australians over the age of 15 who do not participate in any kind of physical activity (an increase from 12% to 14.3% over the same time period).

“We know that prevention is vital to improving the health and welfare of all Australians, a key aim of both strategies,” said Dr Vanessa Prescott, a spokesperson for the AIHW.

“Continued monitoring of the targets is important so we can track improvements and see if they are sustained, as well as drawing attention to areas of stabilisation or regression.”

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