Article Sidebar
Published:
Sep 19, 2007Article Details
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.
Main Article Content
Estimating the burden of disease attributable to smoking in South Africa in 2000
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.
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.
South African Medical Journal Vol. 97 (8) Part 2 2007: pp. 674-681
