Smoking will kill one million annually in India next decade: study

(CBC) - Smoking will cause 930,000 deaths in India in 2010, according to a study published this week in the New England Journal of Medicine.

Of the total number of deaths, the researchers estimate that 580,000 will be among men and 90,000 will be among women between the ages of 30 and 69 years.

Population growth will push the annual number of deaths from smoking in India even higher in the coming decade.

The yearly death rate from smoking will reach about one million people in the next decade, the researchers say, a figure similar to the yearly number of such deaths in China. Most of the deaths are expected to occur in middle age.

The study, published on Thursday in the print edition of the journal, is the first nationally representative study of smoking in India. The researchers - from Canada, the United Kingdom and India - surveyed 1.1 million homes in more than 6,000 areas from all parts of India.

The study estimates that India has about 120 million smokers, leading to deaths mainly from tuberculosis, respiratory disease, heart disease and cancer.

The researchers say the study found that smoking is currently responsible for one in five deaths of middle-aged men and one in 20 deaths of middle-aged women.

"Smoking causes a large and growing number of premature deaths in India," the study reads. "Daily smoking of even a small amount of tobacco was associated with increased mortality."

Dangers outlined

The study found that, among men, about 61 per cent of those who smoke can expect to die at between the ages of 30 and 69, compared with 41 per cent of otherwise similar non-smokers.

Among women, 62 per cent of those who smoke can expect to die in the same age range, compared with only 38 per cent of non-smokers.

According to study, entitled "A Nationally Representative Case-Control Study of Smoking and Death in India," more than one-third of men and five per cent of women between the ages of 30 and 69 smoke either cigarettes or bidis. Wrapped in the leaf of a plant, bidis (pronounced bee-dees) are a type of cigarette that contains about a quarter of the tobacco in a conventional cigarette.

The researchers found that men who smoke bidis shave about six years off their life expectancy, while women who smoke bidis lose about eight years and men who smoke cigarettes lose about 10 years.

The study found that the rate of death from any medical cause in male smokers was 1.7 times that of non-smokers, while in female smokers, the rate of death from any medical cause was double that of female non-smokers.

Prabhat Jha, lead author and a professor at the Centre for Global Health Research, St. Michael's Hospital, University of Toronto, said the study findings were alarming.

"The extreme risks from smoking that we found surprised us," he said.

Tuberculosis killing smokers

The researchers note that the age at which people in India start smoking is older than in Europe and North America, and the amount that each person smokes is lower.

They say India has a relatively low rate of lung cancer, with most of the smoking related deaths resulting from tuberculosis.

To gather data, the researchers hired about 900 field workers to carry out the survey of homes. Each home in which a death had occurred during 2001-2003 was visited by one of the field workers who collected data on cause of death, history of tobacco and alcohol use, and education status. The field workers surveyed all adult deaths in India in that time period.

After that, the researchers compared the smoking histories 74,000 adults who had died to that of 78,000 living people who served as a control group.

The study found there were no safe levels of smoking, but while the risks of smoking a few bidis a day were substantial, the dangers of cigarette smoking were greater.

"Smoking kills, but stopping works," said Richard Peto, an Oxford University professor and co-author of the study.

The study found that only about two per cent of adults have stopped smoking in India and then only after becoming ill.