Tobacco attributable deaths in South Africa
Tobacco attributable deaths in South Africa
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DOI：
10.1136/tc.2004.007682
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发表时间：
2004-12-01
期刊：
影响因子：
5.2
通讯作者：
Peto, R
中科院分区：
文献类型：
--
作者：
Sitas, F;Urban, M;Peto, R
背景：1998年年中，一个问题“死者五年前是否吸烟？设计：对1998年以来的16230份新的死亡通知表进行编码，并通过病例对照比较，比较不同原因死亡者的吸烟流行率，以估计南非的烟草归因死亡率。病例包括已知（从其他研究中）与吸烟有因果关系的原因导致的死亡，对照包括预期与吸烟无关的医疗状况导致的死亡。那些死于外部原因和与酒精消费密切相关的疾病的人被排除在外。主题：报告来自5340名已故成年人（25岁以上），其吸烟状况由家庭成员提供。发现肺结核死亡的风险显著增加（比值比（OR）1.61，95%置信区间（CI）1.23 - 2.11），慢性阻塞性肺疾病（COPD）（OR 2.5，95% CI 1.9 - 3.4），肺癌（OR 4.8，95% CI 2.9 - 8.0），其他上呼吸消化道癌症（OR 3.0，95% CI 1.9 - 4.9）和缺血性心脏病（OR 1.7，95% CI 1.2 - 2.3）。结论：如果吸烟者的死亡率与不吸烟者相同，则肺癌死亡率为58%，COPD死亡率为37%，肺结核死亡率为20%，23%的血管性死亡可以避免。在南非，大约8%的成年人死亡（每年超过2万人死亡）是由吸烟造成的。
Background: In mid 1998, a question "Was the deceased a smoker five years ago?'' was introduced on the newly revised South African death notification form.Design: 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.Subjects: Reports were available from 5340 deceased adults ( age 25+), whose smoking status was given by a family member.Results: 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).Conclusion: 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.