Estimating the changing disease burden attributable to smoking in South Africa for 2000, 2006 and 2012

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dc.contributor.author Groenewald, P.
dc.contributor.author Pacell, R.
dc.contributor.author Sitas, F.
dc.contributor.author Awotiwon, O.F.
dc.contributor.author Vellios, N.
dc.contributor.author Van Rensburg, C.J.
dc.contributor.author Manda, Samuel
dc.contributor.author Laubscher, R.
dc.contributor.author Nojilana, B.
dc.contributor.author Joubert, J.D.
dc.contributor.author Labadarios, D.
dc.contributor.author Ayo-Yusuf, L.
dc.contributor.author Roomaney, R.A.
dc.contributor.author Turawa, E.B.
dc.contributor.author Neethling, I.
dc.contributor.author Abdelatif, N.
dc.contributor.author Pillay-van Wyk, V.
dc.contributor.author Bradshaw, D.
dc.date.accessioned 2023-02-27T05:44:02Z
dc.date.available 2023-02-27T05:44:02Z
dc.date.issued 2022-08
dc.description.abstract BACKGROUND. Ongoing quantification of the disease burden attributable to smoking is important to monitor and strengthen tobacco control policies. OBJECTIVES. To estimate the attributable burden due to smoking in South Africa for 2000, 2006 and 2012. METHODS. We estimated attributable burden due to smoking for selected causes of death in South African (SA) adults aged ≥35 years for 2000, 2006 and 2012. We combined smoking prevalence results from 15 national surveys (1998 - 2017) and smoking impact ratios using national mortality rates. Relative risks between smoking and select causes of death were derived from local and international data. RESULTS. Smoking prevalence declined from 25.0% in 1998 (40.5% in males, 10.9% in females) to 19.4% in 2012 (31.9% in males, 7.9% in females), but plateaued after 2010. In 2012 tobacco smoking caused an estimated 31 078 deaths (23 444 in males and 7 634 in females), accounting for 6.9% of total deaths of all ages (17.3% of deaths in adults aged ≥35 years), a 10.5% decline overall since 2000 (7% in males; 18% in females). Age-standardised mortality rates (and disability-adjusted life years (DALYs)) similarly declined in all population groups but remained high in the coloured population. Chronic obstructive pulmonary disease accounted for most tobacco-attributed deaths (6 373), followed by lung cancer (4 923), ischaemic heart disease (4 216), tuberculosis (2 326) and lower respiratory infections (1 950). The distribution of major causes of smoking-attributable deaths shows a middle- to high-income pattern in whites and Asians, and a middle- to low-income pattern in coloureds and black Africans. The role of infectious lung disease (TB and LRIs) has been underappreciated. These diseases comprised 21.0% of deaths among black Africans compared with only 4.3% among whites. It is concerning that smoking rates have plateaued since 2010. CONCLUSION. The gains achieved in reducing smoking prevalence in SA have been eroded since 2010. An increase in excise taxes is the most effective measure for reducing smoking prevalence. The advent of serious respiratory pandemics such as COVID-19 has increased the urgency of considering the role that smoking cessation/abstinence can play in the prevention of, and post-hospital recovery from, any condition. en_US
dc.description.department School of Health Systems and Public Health (SHSPH) en_US
dc.description.librarian am2023 en_US
dc.description.sponsorship The SAMRC’s Flagships Awards Project. en_US
dc.description.uri http://www.samj.org.za en_US
dc.identifier.citation Groenewald, P., Pacella, R., Sitas, F. et al. 2022, 'Estimating the changing disease burden attributable to smoking in South Africa for 2000, 2006 and 2012', South African Medical Journal, vol. 112, no. 8b, pp. 649-661, DOI : 10.7196/SAMJ.2022.v112i8b.16492. en_US
dc.identifier.issn 0256-9574 (print)
dc.identifier.issn 2078-5135 (online)
dc.identifier.other 10.7196/SAMJ.2022.v112i8b.16492
dc.identifier.uri https://repository.up.ac.za/handle/2263/89820
dc.language.iso en en_US
dc.publisher Health and Medical Publishing Group en_US
dc.rights © 2022 Health & Medical Publishing Group. This work is licensed under a Creative Commons Attribution-NonCommercial Works License (CC BY-NC 3.0). en_US
dc.subject Smoking en_US
dc.subject Tobacco en_US
dc.subject Tuberculosis (TB) en_US
dc.subject South Africa (SA) en_US
dc.title Estimating the changing disease burden attributable to smoking in South Africa for 2000, 2006 and 2012 en_US
dc.type Article en_US


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