Congress logo
Back to Conference page

The 13th World Conference on Tobacco OR Health

Building capacity for a tobacco-free world

July 12-15, 2006, Washington, DC, USA

Thursday, July 13, 2006 - 2:45 PM
23-6

Tobacco attributable deaths in South Africa

Freddy Sitas, D., Phil, Research and Registers Division, Cancer Council New South Wales, P.O.Box 572, Kings Cross,, New South Wales, 1340, Australia, Margaret Irene Urban, MSc, MRC / CANSA / NHLS / WITS Cancer Epidemiology Research Group, National Health Laboratory Service and University of the Witwatersrand, P.O.Box 1038, Johannesburg, 2000, South Africa, Debbie Bradshaw, Burden of Disease Unit, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, Cape Town, 7505, South Africa, Danuta Kielkowski, PhD, Epidemiology, National Institute for Occupational Health, P.O.Box 1038, Johannesburg, 2000, South Africa, Sulaiman Bah, PhD, Vital Registration Section, Statistics SA, Private Bag X44, Pretoria, 0001, South Africa, and Richard Peto, FRS, Clinical Trial Service Unit and Epidemiological Studies Unit.

Objective: To develop a direct method of measuring tobacco attributed mortality

Methods: In mid-1998, a question ‘Was the deceased a smoker five years ago?' was introduced on the South African death notification form. Smoking rates 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 to be causally associated with smoking. Controls comprised deaths from medical conditions unrelated to smoking. Those who died from external causes, and diseases strongly related to alcohol consumption, were excluded.

Results: In this pilot study, reports were available from 5,340 deceased adults (age 25+), whose smoking status was given by a family member. Odds ratios (OR) were standardised for age, sex and education. Significantly increased risks (OR) were found for deaths from tuberculosis (TB: OR = 1.61, 95%CI = 1.2-2.1), chronic obstructive pulmonary disease (COPD: OR = 2.5, 95%CI = 1.9-3.4), lung cancer (OR = 4.8, 95%CI = 2.9-8.0), other upper aerodigestive cancer (OR = 3.0, 95%CI = 1.9-4.9) and ischaemic heart disease (OR = 1.7, 95%CI = 1.2-2.3). If smokers had the same death rate as non-smokers, 58% of lung cancer, 37% of COPD, 20% of TB and 23% of vascular deaths would have been avoided.

Eight percent of all adult deaths in South Africa (> 20,000 annual deaths) were due to smoking. Using death notifications to ask questions about the smoking status of the deceased is a robust way to monitor tobacco-attributed deaths.


See more of The Risk of Tobacco: Global and Regional Estimates
See more of People

See more of The 13th World Conference on Tobacco and Health Conference