Tobacco attributable deaths in South Africa

University of Oxford, Oxford, England, United Kingdom
Tobacco control (Impact Factor: 5.93). 01/2005; 13(4):396-9. DOI: 10.1136/tc.2004.007682
Source: PubMed


In mid 1998, a question "Was the deceased a smoker five years ago?" was introduced on the newly revised South African death notification form.
A total of 16,230 new death notification forms from 1998 have been coded, and comparison of the prevalence of smoking among those who died of different causes was used to estimate, by case-control comparisons, tobacco attributed mortality in South Africa. Cases comprised deaths from causes known (from other studies) to be causally associated with smoking, and controls comprised deaths from medical conditions expected to be unrelated to smoking. Those who died from external causes, and from diseases strongly related to alcohol consumption, were excluded.
Reports were available from 5340 deceased adults (age 25+), whose smoking status was given by a family member.
Significantly increased risks were found for deaths from tuberculosis (odds ratio (OR) 1.61, 95% confidence interval (CI) 1.23 to 2.11), chronic obstructive pulmonary disease (COPD) (OR 2.5, 95% CI 1.9 to 3.4), lung cancer (OR 4.8, 95% CI 2.9 to 8.0), other upper aerodigestive cancer (OR 3.0, 95% CI 1.9 to 4.9) and ischaemic heart disease (OR 1.7, 95% CI 1.2 to 2.3).
If smokers had the same death rate as non-smokers, 58% of lung cancer deaths, 37% of COPD deaths, 20% of tuberculosis deaths, and 23% of vascular deaths would have been avoided. About 8% of all adult deaths in South Africa (more than 20 000 deaths a year) were caused by smoking.


Available from: Freddy Sitas
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    • "Employing a similar calculation procedure to the previous method, this one emerged as a consequence of the objections raised by certain researchers about using RRs to estimate smoking attributable mortality from other countries [33,34]. This method has been used to estimate mortality attributable to tobacco use in China when the epidemic was still in the initial phase [35,36] and South Africa [37]. To apply this method, it is necessary to know the total deaths for all causes among subjects aged 35 years or more for a given period of time. "
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    ABSTRACT: Background One of the most important measures for ascertaining the impact of tobacco is the estimation of the mortality attributable to its use. Several indirect methods of quantification are available. The objective of the article is to assess methodologies published and applied in calculating mortality attributable to smoking. Methods A review of the literature was made for the period 1998 to 2005, in the electronic databases MEDLINE. Twelve articles were selected for analysis. Results The most widely used methods were the prevalence methods, followed by smoking impact ration method. Ezzati and Lopez showed that the general rate of Smoking attributable mortality (SAM) globally was 12% (18% in men). Across countries, attributable fractions of total adult deaths ranged from 8% in Southern Africa, 13.6% in Brazil (18.1% in men) and 25% in Hong Kong (33% in men). Conclusion The variations can be attributed to methodological differences and to different estimates of the main tobacco-related illnesses and tobacco prevalence. All methods show limitations of one type or another, yet there is no consensus as to which furnishes the best information.
    07/2014; 72(1):22. DOI:10.1186/2049-3258-72-22
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    • "Over 44 000 South Africans die every year as a result of some tobacco related diseases (The Heart and Stoke Foundation South Africa, 2009). About 58% of lung cancer deaths, 37% of COPD deaths and 23% of vascular deaths occur in South Africa and these are associated with smoking (Sitas et al., 2004). "
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