We quantified the fraction of cardiovascular deaths attributable to smoking in Germany over time, accounting for population ageing. We calculated population-attributable fractions to quantify cardiovascular deaths attributable to smoking for 1992 to 2021, and compared actual with age-standardized figures. We found a significant decline in the number of cardiovascular deaths attributable to smoking: from about 71 900 cases in 1992 to around 42 000 cases in 2021, with a steeper decline in men. Age-standardized figures suggest that population ageing partially offset this trend. Forward projections indicate increasing trends over the next decade. The results highlight the need for targeted smoking cessation programmes.
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