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

ABSTRACT 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.

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Available from: Freddy Sitas, Sep 25, 2015
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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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    ABSTRACT: The health impacts of tobacco consumption are well documented and have gained acceptance worldwide. Today, a substantial, preventable burden of tobacco attributable diseases exists in most countries, though in most of the cases, unknown. Smoking accounts for almost half of the deaths in middle age in some regions. In Uganda, translating findings into policy action is slow and involves several stakeholders. It will continue to require support from tobacco control campaign groups. This paper analyses secondary literature on tobacco smoking and later provides an appropriate medium based communication strategy that can be adopted to counteract the persuasive smoking evil adverts of tobacco companies as well as creating awareness among the population of the health impacts caused by smoking.
    05/2013; 8(3):59-66. DOI:10.1080/10042857.2010.10684992
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    • "Loss of income, involuntary unemployment and job insecurity appear to lead to increased tobacco consumption, substance abuse and hazardous drinking, all of which could impair immunity [52]. For example, tobacco use increases the immediate risk of TB mortality and longer-term risk of TB spread and reactivation [35], [51]. Alcohol can increase susceptibility to some infectious diseases, such as pneumonia and tuberculosis [38]. "
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    ABSTRACT: There is concern among public health professionals that the current economic downturn, initiated by the financial crisis that started in 2007, could precipitate the transmission of infectious diseases while also limiting capacity for control. Although studies have reviewed the potential effects of economic downturns on overall health, to our knowledge such an analysis has yet to be done focusing on infectious diseases. We performed a systematic literature review of studies examining changes in infectious disease burden subsequent to periods of crisis. The review identified 230 studies of which 37 met our inclusion criteria. Of these, 30 found evidence of worse infectious disease outcomes during recession, often resulting from higher rates of infectious contact under poorer living circumstances, worsened access to therapy, or poorer retention in treatment. The remaining studies found either reductions in infectious disease or no significant effect. Using the paradigm of the "SIR" (susceptible-infected-recovered) model of infectious disease transmission, we examined the implications of these findings for infectious disease transmission and control. Key susceptible groups include infants and the elderly. We identified certain high-risk groups, including migrants, homeless persons, and prison populations, as particularly vulnerable conduits of epidemics during situations of economic duress. We also observed that the long-term impacts of crises on infectious disease are not inevitable: considerable evidence suggests that the magnitude of effect depends critically on budgetary responses by governments. Like other emergencies and natural disasters, preparedness for financial crises should include consideration of consequences for communicable disease control.
    PLoS ONE 06/2011; 6(6):e20724. DOI:10.1371/journal.pone.0020724 · 3.23 Impact Factor
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