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Tob Control. Dec 2004; 13(4): 388–395.
PMCID: PMC1747946

Regional, disease specific patterns of smoking-attributable mortality in 2000

Abstract

Background: Smoking has been causally associated with increased mortality from several diseases, and has increased considerably in many developing countries in the past few decades. Mortality attributable to smoking in the year 2000 was estimated for adult males and females, including estimates by age and for specific diseases in 14 epidemiological subregions of the world.

Methods: Lung cancer mortality was used as an indirect marker of the accumulated hazard of smoking. Never-smoker lung cancer mortality was estimated based on the household use of coal with poor ventilation. Estimates of mortality caused by smoking were made for lung cancer, upper aerodigestive cancer, all other cancers, chronic obstructive pulmonary disease (COPD), other respiratory diseases, cardiovascular diseases, and selected other medical causes. Estimates were limited to ages 30 years and above.

Results: In 2000, an estimated 4.83 million premature deaths in the world were attributable to smoking, 2.41 million in developing countries and 2.43 million in industrialised countries. There were 3.84 million male deaths and 1.00 million female deaths attributable to smoking. 2.69 million smoking attributable deaths were between the ages of 30–69 years, and 2.14 million were 70 years of age and above. The leading causes of death from smoking in industrialised regions were cardiovascular diseases (1.02 million deaths), lung cancer (0.52 million deaths), and COPD (0.31 million deaths), and in the developing world cardiovascular diseases (0.67 million deaths), COPD (0.65 million deaths), and lung cancer (0.33 million deaths). The share of male and female deaths and younger and older adult deaths, and of various diseases in total smoking attributable deaths exhibited large inter-regional heterogeneity, especially in the developing world.

Conclusions: Smoking was an important cause of global mortality in 2000, affecting a large number of diseases. Age, sex, and disease patterns of smoking-caused mortality varied greatly across regions, due to both historical and current smoking patterns, and the presence of other risk factors that affect background mortality from specific diseases.

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Selected References

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  • Ezzati Majid, Lopez Alan D. Estimates of global mortality attributable to smoking in 2000. Lancet. 2003 Sep 13;362(9387):847–852. [PubMed]
  • Ezzati M, Lopez AD. Measuring the accumulated hazards of smoking: global and regional estimates for 2000. Tob Control. 2003 Mar;12(1):79–85. [PMC free article] [PubMed]
  • Liu BQ, Peto R, Chen ZM, Boreham J, Wu YP, Li JY, Campbell TC, Chen JS. Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths. BMJ. 1998 Nov 21;317(7170):1411–1422. [PMC free article] [PubMed]
  • Peto R, Lopez AD, Boreham J, Thun M, Heath C., Jr Mortality from tobacco in developed countries: indirect estimation from national vital statistics. Lancet. 1992 May 23;339(8804):1268–1278. [PubMed]
  • Lan Qing, Chapman Robert S, Schreinemachers Dina M, Tian Linwei, He Xingzhou. Household stove improvement and risk of lung cancer in Xuanwei, China. J Natl Cancer Inst. 2002 Jun 5;94(11):826–835. [PubMed]
  • Law MR, Morris JK, Wald NJ. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ. 1997 Oct 18;315(7114):973–980. [PMC free article] [PubMed]
  • LaCroix AZ, Lang J, Scherr P, Wallace RB, Cornoni-Huntley J, Berkman L, Curb JD, Evans D, Hennekens CH. Smoking and mortality among older men and women in three communities. N Engl J Med. 1991 Jun 6;324(23):1619–1625. [PubMed]
  • Lee PN. Mortality from tobacco in developed countries: are indirect estimates reliable? Regul Toxicol Pharmacol. 1996 Aug;24(1 Pt 1):60–68. [PubMed]
  • Sterling TD, Rosenbaum WL, Weinkam JJ. Risk attribution and tobacco-related deaths. Am J Epidemiol. 1993 Jul 15;138(2):128–139. [PubMed]
  • Malarcher AM, Schulman J, Epstein LA, Thun MJ, Mowery P, Pierce B, Escobedo L, Giovino GA. Methodological issues in estimating smoking-attributable mortality in the United States. Am J Epidemiol. 2000 Sep 15;152(6):573–584. [PubMed]
  • Thun MJ, Apicella LF, Henley SJ. Smoking vs other risk factors as the cause of smoking-attributable deaths: confounding in the courtroom. JAMA. 2000 Aug 9;284(6):706–712. [PubMed]
  • Ezzati Majid, Lopez Alan D, Rodgers Anthony, Vander Hoorn Stephen, Murray Christopher J L. Selected major risk factors and global and regional burden of disease. Lancet. 2002 Nov 2;360(9343):1347–1360. [PubMed]
  • Krishnan P, Mungherera Margaret, Jones Sinéad B. Tobacco and the Commonwealth: a call to action. Lancet. 2003 May 17;361(9370):1669–1670. [PubMed]
  • Gajalakshmi Vendhan, Peto Richard, Kanaka Thanjavur Santhanakrishna, Jha Prabhat. Smoking and mortality from tuberculosis and other diseases in India: retrospective study of 43000 adult male deaths and 35000 controls. Lancet. 2003 Aug 16;362(9383):507–515. [PubMed]

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