Researchers today [Friday 23 August] call for official death registries in all countries to record whether the dead person was a smoker, in a research Article published in The Lancet. New analyses of nearly half a million death records in South Africa – the first, and so far the only, country to record smoking on death registration forms – show that the death rate from tobacco is more than twice as great in the coloured (mixed ancestry) as in the white population.
The study, which is the first large-scale analysis of mortality from smoking in any African country, found that in the coloured population smoking causes one in four of all deaths in middle-aged men and one in six of all deaths in middle-aged women.
At ages 35 – 64 years, the excess risk of death among smokers was greater in the coloured than in the white population (men 14·2% vs 7·6%, women 11·0% vs 7·7%), as was the proportion who had smoked (men 68% vs 47%, women 46% vs 28% at these ages). These findings imply that, for both men and women, the death rate from smoking is more than twice as great in the coloured as in the white population.
The black (African) population already accounts for more than half of all deaths from smoking in South Africa, due to its larger size. At present, the death rate from smoking is not yet as high in the black as in the white population, but the researchers warn that this is likely to change if the large numbers of young black adults who now smoke continue to do so. The system of recording smoking on death notification forms will, however, automatically monitor any future changes in the death rate from smoking.
South Africa modified its national death notification form in 1998 to ask a simple yes/no question about whether the dead person had been a smoker five years earlier. An international team of researchers has analysed the answers about smoking on the death notification forms of nearly half a million (481 640) adults in South Africa who died during 1999 – 2007. The excess of smokers among people who died of diseases such as lung cancer, chronic lung disease, tuberculosis, heart attack, and stroke indicated for each disease the proportion of the deaths that had been caused by smoking.
According to Professor Debbie Bradshaw, lead author of the study, “There is already a high death rate from smoking in the mixed-ancestry coloured population of South Africa, and there will be major increases in tobacco-attributed mortality in many other African populations where young adults now smoke, unless there is widespread cessation.”