Estimating the burden of disease attributable to smoking in South Africa in 2000

Groenewald, Pam, Vos, Theo, Norman, Rosana, Laubscher, Ria, Van Walbeek, Corne, Saloojee, Yussuf, Sitas, Freddy, Bradshaw, Debbie and The South African Comparative Risk Assessment Collaborating Group (2007) Estimating the burden of disease attributable to smoking in South Africa in 2000. SAMJ South African Medical Journal, 97 8; Pt. 2: 674-681.

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Author Groenewald, Pam
Vos, Theo
Norman, Rosana
Laubscher, Ria
Van Walbeek, Corne
Saloojee, Yussuf
Sitas, Freddy
Bradshaw, Debbie
The South African Comparative Risk Assessment Collaborating Group
Title Estimating the burden of disease attributable to smoking in South Africa in 2000
Journal name SAMJ South African Medical Journal   Check publisher's open access policy
ISSN 0256-9574
Publication date 2007-08
Year available 2007
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 97
Issue 8; Pt. 2
Start page 674
End page 681
Total pages 8
Place of publication Claremont, South Africa
Publisher Health and Medical Publishing Group
Collection year 2008
Language eng
Subject C1
321203 Health Information Systems (incl. Surveillance)
111799 Public Health and Health Services not elsewhere classified
11 Medical and Health Sciences
1117 Public Health and Health Services
Formatted abstract
Objectives: To quantify the burden of disease attributable to smoking in South Africa for 2000.

Design: The absolute difference between observed lung cancer death rate and the level in non-smokers, adjusted for occupational and indoor exposure to lung carcinogens, was used to estimate the proportion of lung cancer deaths attributable to smoking and the smoking impact ratio (SIR). The SIR was substituted for smoking prevalence in the attributable fraction formula for chronic obstructive pulmonary disease (COPD) and cancers to allow for the long lag between exposure and outcome. Assuming a shorter lag between exposure and disease, the current prevalence of smoking was used to estimate the population-attributable fractions (PAF) for the other outcomes. Relative risks (RR) from the American Cancer Society
cancer prevention study (CPS-II) were used to calculate PAF.

Setting: South Africa.

Outcome measures:
Deaths and disability-adjusted life years (DALYs) due to lung and other cancers, COPD, cardiovascular conditions, respiratory tuberculosis, and other respiratory and medical conditions.

Results: Smoking caused between 41 632 and 46 656 deaths in South Africa, accounting for 8.0 - 9.0% of deaths and 3.7 - 4.3%of DALYs in 2000. Smoking ranked third (after unsafe sex/sexually transmitted disease and high blood pressure) in terms
of mortality among 17 risk factors evaluated. Three times as many males as females died from smoking. Lung cancer had the largest attributable fraction due to smoking. However, cardiovascular diseases accounted for the largest proportion of deaths attributed to smoking.

Cigarette smoking accounts for a large burden of preventable disease in South Africa. While the government has taken bold legislative action to discourage tobacco use since 1994, it still remains a major public health priority.
Keyword Tobacco
Lung cancer
Q-Index Code C1
Q-Index Status Confirmed Code

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Created: Mon, 18 Feb 2008, 15:12:27 EST