Cancer cases attributable to modifiable lifestyle risk factors in Switzerland between 2015 and 2019.

Several modifiable lifestyle risk factors have been linked to higher cancer risk in the literature. Determining the proportion and number of cancer cases attributable to these risk factors is pivotal in informing effective cancer prevention and control plans that have the greatest effect on reducing cancer incidence. We aimed to estimate the proportion and number of incident cancer cases that were attributable to modifiable lifestyle risk factors (ie, tobacco smoking, high alcohol consumption, excess body weight, physical inactivity and unhealthy diet) in Switzerland between 2015 and 2019. The exposure prevalence of selected risk factors was estimated based on the representative national nutrition survey menuCH, the associated relative risks were obtained from systematic literature reviews and the numbers of incident cancer cases were provided by the National Institute for Cancer Epidemiology and Registration. The fractions and numbers of attributable cases were calculated overall, by sex and by the three major language regions of Switzerland. The investigated modifiable risk factors combined were linked to 25.2% of potentially preventable incident cancer cases in Switzerland between 2015 and 2019. The proportion and numbers were slightly larger in males (28.4%, 6945 cases per year) than in females (21.9%, 4493 cases per year), and variations were observed between language regions. Tobacco smoking, excess body weight and high alcohol consumption were the leading contributors to lifestyle-attributable cancer cases. The observed differences in the leading risk factors both within Switzerland and compared to other countries underline the need for regionally and nationally tailored cancer prevention and education strategies.

Cross-country and panel data estimates of the price elasticity of demand for cigarettes in Europe.

OBJECTIVE: Our goal is to provide estimates of the price elasticity of demand for cigarettes in Europe as a basis for public health policy on tobacco taxation. METHODS: We use secondary data on cigarette retail sales including illicit trade, prices, tobacco control measures and income from 2010 to 2020 of 27 European countries from Euromonitor, the WHO, the Tobacco Control Scale and the World Bank. We estimate the price elasticity of demand using instrumental variable regressions as well as panel data regressions taking into account that prices and quantities are determined simultaneously in the market. RESULTS: Based on cross-section data at the country level, we find that during the decade from 2010 to 2020, the demand for cigarettes in Europe has become neither more nor less elastic. Our estimates of the price elasticity based on panel data are around -0.4 (95% CI -0.67 to -0.24), in line with previous estimates for high-income countries. Furthermore, our analysis shows that estimates of the price elasticity of demand that are based on data including illicit trade tend to be lower. This has also been found in the previous literature. CONCLUSIONS: By providing state-of-the-art, up-to-date estimates of the price elasticity of demand that are in line with the previous literature, we show that taxation can still be a cost-effective tobacco policy to reduce cigarette consumption and thus, the burden of smoking.

Burden of smoking on disease-specific mortality, DALYs, costs: the case of a high-income European country.

BACKGROUND: Smoking is a major risk factor for chronic diseases causing early death and disability. Smoking prevalence over the past 25years has remained high in Switzerland. Evidence about the burden of disease and cost of illness attributable to smoking can support tobacco control. The aim of the present paper is to quantify from a societal perspective the mortality, disability-adjusted life years (DALYs), medical costs and productivity losses attributable to smoking in Switzerland in 2017. METHODS: Smoking attributable fractions (SAFs) were calculated based on the prevalence of current and former active smoking in the latest Swiss Health Survey from 2017 and relative risks from the literature. The SAFs were then multiplied with the number of deaths, DALYs, medical costs and productivity losses in the total population. RESULTS: In the Swiss population in 2017 smoking accounted for 14.4% of all deaths, for 29.2% of the deaths due to smoking-related diseases, 36.0% of the DALYs, 27.8% of the medical costs and 27.9% of productivity losses. Total costs amounted to CHF 5.0 billion which equals CHF 604 per capita per year. The highest disease burden in terms of mortality and DALYs attributable to smoking was observed for lung cancer and chronic obstructive pulmonary disease (COPD), whereas the highest cost of illness in terms of medical costs was observed for coronary heart diseases and lung cancer and in terms of productivity losses for COPD and coronary heart diseases. Sex and age group differences were found. CONCLUSIONS: We provide an estimate of the burden of smoking on disease-specific mortality, DALYs, medical costs and productivity losses in Switzerland that could be prevented through evidence-based tobacco prevention and control policies as well as regular monitoring of tobacco consumption.

Have Swiss adult males and females stopped growing taller? Evidence from the population-based nutrition survey menuCH, 2014/2015.

Data from the National Nutrition Survey for adults (menuCH) allow for the assessment of recent trends in measured height by year of birth for adult men and women from a population-based sample. The aim of the present study was to test if - similarly to conscripts and schoolchildren - the Swiss adult population stopped growing taller in recent birth cohorts, and if so, when the change occurred. We found that - when self-reported - height was overestimated on average by about 1 cm in both men and women, with an increasing tendency with older age and with shorter height. Average measured height increased by 4.5-5.0 cm for adult men and women between the birth years 1937-1949 and 1990-1995. However, this increase was not linear, and starting with the 1970s birth years, average height plateaued on a level of about 178 cm for men and 166 cm for women. Being born outside of Switzerland or adjustment for potential shrinkage with increasing age did not change this temporal pattern. We also found shorter average height among participants from the Italian part of Switzerland and those with lower educational level. It remains unclear if the phenomenon of stabilisation affects all subgroups of the Swiss population. Future studies should combine a larger number of population-based surveys to enhance the sample size, for example, for people with a migration background or with different educational levels. Continuing growth monitoring needs to be performed to assess if environmental and demographic changes with an impact on body growth (adverse trends in nutrition, increasing social inequality in health, ethnic composition of the population) positively or negatively influence future trends in average height.

Clustering of sociodemographic and lifestyle factors among adults with excess weight in a multilingual country.

OBJECTIVE: The aim of this study was to identify and cluster potential sociodemographic and lifestyle determinants of excess weight (body mass index ≥ 25 kg/m2) in Switzerland. METHODS: Participants of the cross-sectional National Nutrition Survey menuCH (2014-2015, n = 2057) were categorized according to body mass index. Logistic regressions were conducted with sociodemographic (age, language region, education, household income, household status) and lifestyle factors (smoking, self-rated health status, physical activity, energy intake, Alternate Healthy Eating Index) to identify determinants of excess weight. Factorial analysis and clustering were applied to identify patterns among individuals with excess weight (n = 891). RESULTS: Poor or very poor self-rated health status and low levels of physical activity were associated with increased odds for obesity in men (odds ratio [OR] = 5.39 [95% confidence interval = 5.30-5.48], OR = 2.51 [2.14-2.95], respectively) and women (OR = 12.40 [11.59-13.26], OR = 4.83 [3.04-7.67], respectively). In both sexes, the Alternate Healthy Eating Index score was inversely associated with the probability of having obesity. Cluster analysis identified four distinct patterns: "young living with parents" (14.6%), "men with high educational level" (41.5%), "women living alone" (34.9%), and "low educational level and Italian language region" (9.0%). CONCLUSIONS: We identified four discrete subgroups of individuals with excess weight who differed by sociodemographic and lifestyle factors. Such subgroups may prove useful for targeted public health interventions.