A pandemic of smoking-related death and disease is poised to claim a million lives each year in India unless something is done soon to turn the situation around, warns a major new study in the New England Journal of Medicine.
The largest-ever survey of Indian smoking habits and their relation to mortality was led by Dr. Prabhat Jha, from the University of Toronto's Centre for Global Health Research. He and his team drew on a nationally representative sampling of 1.1 million Indian homes to compare the incidence of smoking among 74,000 men and women over 20 years of age who had died between 2001 and 2003 to that of 78,000 living adults.
More than half of the deceased males had smoked (51%) compared to 32% of living controls; the rates for women were 9% and 4%, respectively.
Overall, smoking more than doubled the cancer death risk for both sexes, the researchers found. The habit also tripled the odds of dying from tuberculosis or other respiratory disease for women, and more than doubled the risk for men. Cardiovascular risks were also 60 to 70 percent higher among smoking men and women compared to nonsmokers, the study found.
All of this is taking an enormous toll in excess mortality among India's estimated 120 million smokers, the researchers say. In fact, the study concludes that, "Smoking in persons between the ages of 30 and 69 years is responsible for about 1 in 20 deaths of women and 1 in 5 deaths of men" in India and that by 2010, "smoking will cause about 930,000 adult deaths (annually) in India." That number will be about one million as the decade progresses, the researchers added.
Use of cigarettes &ndash and the even more popular, cheaper leaf-rolled bidis &ndash will cause female smokers in India to lose an average of 8 years of expected lifespan, and shorten male smokers' lives by an average of 6 years, Jha's group estimated.
What to do? In an earlier article in Cancer Prevention, Jha noted that India is but one of a number of developing countries that can expect a "pandemic" of smoking-related death over the coming decades. But he said that grim lessons learned from a similar pandemic in the West during the 20th century can help India to avoid the same fate.
Steps that have proven effective in reducing smoking's death toll in Europe and North America include boosting tobacco taxes, encouraging effective smoking-cessation programs, banning smoking in public areas, and other interventions. Similar interventions can work in India and other developing countries as well, Jha believes.
"A history of tobacco deaths need not be a destiny of tobacco death," he contends. "We know much more than we did even one decade ago. The only question is whether we will use it."
