Nearly 5 million deaths worldwide caused by smoking

The latest epidemiological assessment for the global effect of smoking on deaths worldwide is detailed in this week’s issue of THE LANCET. Smoking-related deaths for the year 2000 were as high in developing countries than in industrialised areas of the world, with 84% of such deaths in developing countries being among male smokers.

To strengthen the scientific evidence for national and global tobacco control efforts, a consistent method is needed to estimate the health effects of smoking across different populations and different points in time. Majid Ezzati from Harvard School of Public Health, Boston, USA, and Alan Lopez from the University of Queensland, Australia, extended estimation of smoking-related deaths to less-developed countries-where an estimated 930 million of the world’s 1.1 billion smokers live. Deaths from lung cancer among non-smokers was an important baseline in the study for the measurement of smoking deaths across different populations.

The investigators estimate that 4.8 million deaths in 2000 were attributable to smoking, with a similar toll in both developed and less-developed countries. Over three-quarters of all smoking deaths worldwide were among men-this proportion increased to 84% of men in less-developed countries. The main causes of death worldwide were cardiovascular disease (1.7 million deaths), chronic obstructive pulmonary disease (just under a million deaths), and lung cancer (around 850,000 deaths).

Majid Ezzati comments: “As the hazards of smoking accumulate among those who began smoking in developing countries over the past few decades, coupled with population growth and ageing, mortality as a result of smoking will rise substantially unless effective interventions and policies that curb and reduce smoking among men and prevent increases among women in these countries are implemented.”