In 2016, 7·1 million (6·5 million to 7·8 million) deaths and 177·3 million (162·3 million to 194·3 million) DALYs were attributable to tobacco, most of which is attributable to smoking tobacco. Smoking-attributable deaths have increased by 20·1% (15·3–25·2) since 1990, with most deaths occurring in China, India, the USA, and Russia. Smoking is the second-leading risk factor for men for deaths and leading for DALYs, accounting for 16·3% (14·6–17·9) of deaths and 9·5% (8·5–10·7) of DALYs, and the sixth for women for deaths and ninth for DALYs, with 5·8% (5·0–6·7) of deaths and 2·9% (2·5–2·94) of DALYs. In 2016, there were 177·3 million (162·3 million to 194·3 million) smoking-attributable DALYs globally. Overall, in 2016 chronic respiratory diseases (30·3% [25·2–36·0]), neoplasms (19·2% [16·0–22·8]), and cardiovascular diseases (18·0% [16·0–20·0] were the three leading causes of smoking-attributable age-standardised DALYs across both sexes. For women, the leading cause of DALYs was COPD, whereas the leading cause for men was IHD.
