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Smoking and Death in India

Strict Embargo: Wed. Feb. 13, 2008, 5PM EST (Toronto) Wed. Feb. 13, 2008 10PM GMT (London) Thur. Feb. 14, 2008 3:30AM IST (New Delhi). Smoking and Death in India. On behalf of the RGI-CGHR Investigators Sources of support:

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Smoking and Death in India

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  1. StrictEmbargo: Wed. Feb. 13, 2008, 5PM EST (Toronto) Wed. Feb. 13, 2008 10PM GMT (London) Thur. Feb. 14, 2008 3:30AM IST (New Delhi) Smoking and Death in India On behalf of the RGI-CGHR Investigators Sources of support: ICMR and RGI (India); FIC, NIH (US); IDRC & CIHR (Canada); CTSU, MRC & CR-UK (UK) Centre for Global Health Research (CGHR) Keenan Research Centre at the Li Ka Shing Knowledge Institute St. Michael’s Hospital, University of Toronto prabhat.jha@utoronto.ca

  2. Key messages for the individual smoker in India • Risk BIGGER than previously thought • Smoking kills EARLY: 70% smoking deaths are at ages 30-69, losing decades of good life • Even a FEW bidis or cigarettes per day kills • STOPPING SMOKING WORKS – but, only 2% of adults in India have quit

  3. Nationally representative sample (Sample Registration System) • 6,671 of these small areas randomly chosen from all parts of India (each with about 1000 people per area)

  4. How was the study done? 900 non-medical staff monitored 1.1 M (11 lakh) homes for three years (2001-3) 2 physicians assigned underlying fatal disease (eg TB) All adult deaths from diseases (74,000 deaths) Obtain smoking history of the dead from living household members Compare smoking history of the dead to smoking history of 78,000 living adults

  5. What’s new about this research? • Large size of study • Nationally representative study of the causes of deaths in adults: results reflect the whole of India • First reliable study of female deaths from smoking in India

  6. Smoking prevalence in India Cigarettes or bidis (less tobacco than a cigarette, wrapped in the leaf of another plant)

  7. Indian Women aged 30-69No. of deaths studied and smoker vs nonsmoker death rate ratio (RR) *versus 4.5% of 26,678 living women who had smoked † Risk ratio adjusted for age, alcohol use and education

  8. Indian Men aged 30-69No. of deaths studied and smoker vs nonsmoker death rate ratio (RR) *versus 37.0% of 31,661 living men who had smoked † Risk ratio adjusted for age, alcohol use and education

  9. Smoking kills all categories of men results for men aged 30-69 Smoker vs Nonsmoker Risk Ratio *adjusted for age, alcohol use and education

  10. Any smoking kills *adjusted for age, alcohol use and education

  11. Cumulative risk of death, from age 30smokers vs nonsmokers Women *adjusted for age, alcohol use and education

  12. Cumulative risk of death, from age 30smokers vs nonsmokers Men *adjusted for age, alcohol use and education

  13. Disease-specific risks of death, ages 30-69smokers vs nonsmokers * Women *risk in the absence of other causes of death, adjusted for age, alcohol use and education

  14. Disease-specific risks of death, ages 30-69smokers vs nonsmokers * Men *risk in the absence of other causes of death, adjusted for age, alcohol use and education

  15. Deaths from smoking in year 2010 in India, ages 30-69, by disease

  16. Deaths from smoking in year 2010 in India Annual deaths from smoking will rise from 930,000 to 1,000,000 (10 lakh) during 2010s

  17. INDIA: 1 million (10 lakh) smoking deaths per year during 2010s • Smoking causes 10% of the 10 million (1 crore) deaths per year from all causes • 70% of smoking deaths are in middle age (30-69): 700,000 (7 lakh); 600,000 men and 100,000 women • 1 in 5 of all adult male deaths and 1 in 20 of all adult female deaths in middle age • Over 1/2 of smoking deaths are in illiterate adults

  18. Key messages for the individual smoker in India • Risk BIGGER than previously thought • Smoking kills EARLY: 70% smoking deaths are at ages 30-69, losing decades of good life • Even a FEW bidis or cigarettes per day kills • STOPPING SMOKING WORKS – but, only 2% of adults in India have quit

  19. Embargoed press materials on: www.cghr.org/tobacco • NEJM Paper and Supplementary Appendix • Press releases: English, Hindi and regional languages • Video release: English, Hindi and regional languages • Quotes from noted scientists, celebrities, others • Frequently-asked questions • PowerPoint slides in English • Information about CGHR and partners * Also at http://www.ctsu.ox.ac.uk/indiatobacco

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