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The Belgian National Burden of Disease Study quantifies the health impact of 38 key diseases using Disability-Adjusted Life Years (DALYs), which indicate healthy years lost due to illness and death. This chapter focuses on estimating the disease burden linked to various risk factors, emphasizing that a significant portion is preventable by addressing modifiable risk factors such as tobacco use, alcohol use, dietary risk, or physical activity. Other risk factors, such as metabolic, and environmental risks, will also be considered. The portion of the disease burden that could be reduced by minimizing or eliminating exposure to risk factors is called the attributable burden. The attributable burden due to a risk factor can be expressed in terms of morbidity and mortality.  

Smoking is causally linked to the burden of 41 diseases including 19 types of cancer, 7 cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and asthma.

In 2020, tobacco use was responsible for 9413 deaths, accounting for 7.4% of all deaths in Belgium. The leading causes of death due to tobacco use where namely lung cancer, COPD, and ischemic heart disease. 

The disease burden related to smoking is mostly borne by men and the elderly (65+).

Despite a decrease, the death rate remains highest in the Brussels Capital Region, followed by the Walloon Region, with smoking-related death rates 50% higher in the 2 regions compared to the Flemish Region. Among EU-14 countries, Belgium ranks 5th worst for smoking-related deaths.