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Crisis in India: Smoking Expected to Kill 1 Million People Annually by 2010

WHO aims to prevent cancer deaths by reducing smoking in developing nations

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Smoking cigarette
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Smoking kills 900,000 people every year in India, and unless corrective action is taken soon that number will increase to 1 million smoking-related deaths annually by 2010 and beyond, according to a study published in the New England Journal of Medicine and conducted by scientists from India, Canada and the UK. For the study, 900 field workers gathered information from a sample of 1.1 million homes in all parts of India.

Highlights of the study include:

  • Smoking may soon account for 20 percent of all male deaths and 5 percent of all female deaths among Indians between the ages of 30 and 69.

  • About 61 percent of men who smoke can expect to die between the ages of 30 and 69, compared with only 41 percent of non-smoking men who are similar in other ways.

  • About 62 percent of women who smoke can expect to die between the ages of 30 and 69, compared to only 38 percent of non-smoking women.

  • On average, men who smoke bidi—the popular hand-rolled cigarettes that contain about one-quarter as much tobacco as a full-sized cigarette—shorten their lives by about six years. Men who smoke full-sized cigarettes lose about 10 years of life.

  • Bidi-smoking women shorten their lives by about eight years on average.

  • Smoking 1-7 bidis a day, for example, raised mortality risks by 25 percent while smoking an equal number of cigarettes daily doubled the risk of death to 50 percent.
The study did not examine the mortality risks of secondhand smoke, which the U.S. Surgeon General has declared a significant health hazard for non-smokers, especially children.

"It is truly remarkable that one single factor, namely smoking, which is entirely preventable, accounts for nearly one in 10 of all deaths in India,” said Harvard University Professor Amartya Sen. "The study brings out forcefully the need for immediate public action in this much-neglected field."

Half of Smoking Deaths Occur Among Illiterate Indians
There are approximately 120 million smokers in India, about 37 percent of all men and 5 percent of all women between the ages of 30 and 69. The government is taking several steps to control tobacco use, including making special efforts to inform people who are poor or illiterate about the dangers of smoking. According to the study, more than 50 percent of the tobacco-related deaths in India occur among illiterate men or women, and 80 percent of those people reside in rural India.

Indian health authorities have urged the government to do more, but some politicians oppose further action because they want to protect the jobs of tobacco workers.

Smoking Deaths On the Rise in Developing Nations Worldwide
The projected increase in smoking-related deaths in India is part of a global trend, according to the World Health Organization (WHO), which estimates that smoking-related deaths worldwide will surpass 9 million annually by 2020—with 7 million of those deaths occurring in developing nations.

Twenty-five years ago, nearly 70 percent of the lung cancer deaths worldwide occurred in high-income nations. Today, 50 percent of lung cancer deaths occur in low-income nations, and by 2030 that number is expected to increase to 70 percent.

Tobacco Companies Targeting Developing Nations
One reason for the change is that consumer education, regulation and societal pressure have lowered smoking rates in many developed countries, which has also brought down the number of smoking-related deaths in those nations. Another reason for the shift is that tobacco companies have mounted aggressive marketing campaigns in developing countries, where there are few restrictions on how they sell or advertise their products, to help compensate for decreased smoking rates and lower profits in developed nations.

Currently, 1.3 billion people worldwide smoke or use other tobacco products, and nearly 5 million die as a result. Eighty-four percent of the world’s tobacco users live in countries with developing or transitional economies.

WHO Takes Aim at Cancer and Tobacco Use
WHO has started a global effort to reduce cancer deaths worldwide—aiming to prevent 8 million cancer deaths by 2015—and a primary focus of that initiative is to lower tobacco use in developing countries.

"Even if smoking rates stayed the same worldwide, we would see a huge increase in cancer incidence in the next decades just because of the growth and aging of the population," said Peter Boyle, Ph.D, director of the International Agency for Research on Cancer in Lyon, France, a WHO research organization. "Whereas there were 100 million deaths in the 20th century caused by tobacco, if current trends continue, there will be 1 billion in the 21st century. Tobacco is the biggest enemy we face.”

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