title: Estimating the burden of disease attributable to smoking in South Africa in 2000
creator: Groenewald, Pam
creator: Vos, Theo
creator: Norman, Rosana
creator: Laubscher, Ria
creator: van Walbeek, Corne
creator: Saloojee, Yussuf
creator: Sitas, Freddy
creator: Bradshaw, Debbie
contributor: South African Comparative Risk Assessment Collaborating Group
subject: 110000 MEDICAL AND HEALTH SCIENCES
subject: 111700 PUBLIC HEALTH AND HEALTH SERVICES
subject: 111706 Epidemiology
subject: 111799 Public Health and Health Services not elsewhere classified
subject: anzsrc Australian and New Zealand Standard Research Class
subject: carcinogen
subject: adult
subject: aged
subject: article
subject: Asian
subject: cancer mortality
subject: cardiovascular disease
subject: Caucasian
subject: chronic obstructive lung disease
subject: cigarette smoking
subject: controlled study
subject: disability
subject: ethnic difference
subject: female
subject: government
subject: human
subject: hypertension
subject: Indian
subject: indoor air pollution
subject: ischemic heart disease
subject: law
subject: lung cancer
subject: lung tuberculosis
subject: major clinical study
subject: male
subject: mortality
subject: Negro
subject: occupational exposure
subject: outcome assessment
subject: prevalence
subject: quantitative analysis
subject: respiratory tract cancer
subject: respiratory tract disease
subject: risk assessment
subject: sex ratio
subject: sexually transmitted disease
subject: smoking cessation
subject: South Africa
subject: stroke
subject: unsafe sex
subject: adolescent
subject: age distribution
subject: cost of illness
subject: middle aged
subject: race
subject: smoking
subject: statistics
subject: tobacco dependence
subject: Continental Population Groups
subject: Humans
subject: Sex Distribution
subject: Tobacco Use Disorder
description: 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.     Conclusion    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.
publisher: Health and Medical Publishing Group
date: 2007
type: Journal Article
format: application/pdf
relation: https://eprints.qut.edu.au/79832/1/SA%20CRA%20smoking.pdf
relation: http://www.samj.org.za/index.php/samj/article/view/656/153
relation:    Groenewald, Pam, Vos, Theo, Norman, Rosana, Laubscher, Ria, van Walbeek, Corne, Saloojee, Yussuf, Sitas, Freddy,  & Bradshaw, Debbie   (2007)    Estimating the burden of disease attributable to smoking in South Africa in 2000.  South African Medical Journal, 97(8), pp. 674-681.    
identifier: https://eprints.qut.edu.au/79832/
rights: Copyright 2007 Health and Medical Publishing Group
source: Faculty of Health; Institute of Health and Biomedical Innovation