The 13th World Conference on Tobacco OR Health

Objective: The gender gap in life expectancy has been recognized throughout the world, and yet, reasons why the female have such advantages have not been quantified, leaving efforts to reduce the disparity unfocused. As males smoke more in Taiwan, the extent of the contribution by smoking rate difference to the composition of the gender gap in life expectancy will be estimated.

Methods: Using the decomposition method, the contribution of each smoking related cause to life expectancy in Taiwan was calculated. The gender-specific smoking rate and relative mortality risks were used to develop the population-attributable fraction (PAF) for each disease category. The smoking-attributable gender gap was the sum of the difference in PAF between genders for each smoking related disease, multiplied by the number of years this disease contributed to the life expectancy gap.

Results: Differences in smoking rates (46% versus 5%) contributed one-third (1.88/5.66 years) of the life expectancy gap between males and females. Among specific diseases, 31%, 41%, 37% and 41% of life expectancy differences in cancers, cardiovascular diseases, diseases of respiratory system and diseases of digestive system, respectively, were attributed to by smoking differences between genders. The significance of results remained after sensitivity analyses were conducted.

Conclusion: Smoking represents a major factor for the observed gender gap in life expectancy. Reducing the smoking prevalence gap can substantially narrow the health disparity between the sexes in Taiwan, with one third of life expectancy gap eliminated.