Smoking causes half the tuberculosis deaths in ...( An international study in this week's i...),Health

Most adult deaths in India involve vascular disease, pulmonary tuberculosis, or other respiratory disease. In the first major study of how smoking causes death in India, Vendhan Gajalakshmi from Chennai's Epidemiology Research Centre and her colleagues compared the tobacco smoking of 43,000 men (from both urban and rural areas) who had died of various diseases in the late 1990s with that of 35,000 living men (the control group).

In the urban study area, the death rates from medical causes of ever smokers were double those of never smokers. The risks were substantial both for cigarette smoking (the main urban habit) and for bidi (small cigarettes popular in Asia) smoking. Of this excess mortality among smokers, most involved respiratory disease (chiefly tuberculosis) or vascular disease (chiefly heart attack). Smoking also caused similar excesses of respiratory and vascular mortality in the rural study area.

Vendhan Gajalakshmi comments: "More than 4000 of these deaths were from TB, but if smokers had had the same low risks as non-smokers there would have been fewer than 2000 TB deaths. Half the extra TB deaths were at ages 25-54. In total, about a quarter of all smokers are killed by smoking at ages 25-69-those killed at these ages lose 20 years of life on average."

Co-author Richard Peto from the University of Oxford,UK, adds: "About a billion people worldwide are carrying live tuberculosis infection in their lungs, but if they do not smoke then most will never become seriously ill from TB. Smoking increases the danger that any TB infection already in the lungs will get out of control and cause clinical TB, which can kill and can easily be spread to other people. In some parts of the world the main way
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Contact: Joe Santangelo
j.santangelo@elsevier.com
212-633-3810
Lancet
14-Aug-2003