The risk of corruption: exploring the relationship between corruption and smoking-related mortality in the OECD

This study examines whether perceived public-sector corruption is associated with adult daily smoking prevalence and six smoking-attributable mortality indicators across the OECD (Organisation for Economic Co-operation and Development). Drawing on publicly available national data from the 36 OECD member states (2012–2019), we conducted an ecological, cross-sectional analysis using correlation and backward-elimination regression modelling. Our main outcome measures were smoking prevalence and age-standardised deaths per 100,000 population for all-cause, preventable, and treatable mortality as well as mortality due to acute myocardial infarction, ischaemic heart disease, and cerebrovascular accidents. The findings reveal that countries with higher Corruption Perceptions Index (CPI) scores, indicating lower corruption, demonstrated significantly lower smoking prevalence and reduced mortality across all smoking-attributable indicators. Backward-elimination regressions identified corruption perceptions as the sole independent predictor of smoking prevalence and treatable mortality with no other socioeconomic variables retaining significance in final models. Across OECD member states, lower perceived corruption levels are consistently associated with reduced smoking prevalence and decreased smoking-attributable mortality. While cross-sectional design precludes causal inference, this research suggests that governance quality represents an important but underexplored structural determinant of tobacco-related health outcomes, with implications for both anti-corruption efforts and public-health policy implementation.