Smoking attributable mortality

Centers for Disease Control and Prevention. Annual smoking-attributable mortality, years of potential life lost and economic costs—United States, 1995-1999. Morb Mortal Wkly Rep (MMWR) 2002 51 300-3. www.cdc. gov/mmwr//preview/mmwrhtml/mm5114a2.htm... 

TABLE 15.3. Number of Deaths and Smoking Attributable Mortality (SAM) of Selected Cancers in Males and Females—United States, 1997-2001 (CDC, 2005)... 

Shopland DR, Eyre JH, Pechacek TF. Smoking-attributable cancer mortality in 1991 is lung cancer now the leading cause of death among smokers in the United States JNatl Cancer Inst 1991 83 1142-1148. 

Ezzati, M., Lopez, A. Estimates of global mortality attributable to smoking in 2000. Lancet. 362 847, 2003. 

National trends of cardiovascular mortality are incompatible with these risk estimates excess deaths may not be attributable entirely to smoking the clinical diagnosis of thromboembolism is often unreliable. 

Donora in Pennsylvania, and London. Excess mortality accompanied each of these pollution episodes and has been attributed to the smoke and sulfur dioxide generated by fossil fuel combustion. A number of recent epidemiologic, clinical, and animal studies have confirmed that both particulate matter and sulfur oxides produce adverse health effects. These adverse effects have been observed during pollution episodes in which the gas and particle concentrations do not approach the magnitude of the three incidences mentioned previously. Delineating the relative contribution of particulate matter and sulfur oxides to these adverse effects is difficult because of the chemicophysical association of sulfur oxides and particles. This section is limited to the current state of knowledge on sulfur oxides and acid aerosol-related health effects. The following section will discuss particulate matter-related effects. 

Estimated annual excess cases of childhood illness and death attributable to parental smoking in the United States include low birth weight (46,000 cases, 2800 perinatal deaths), sudden infant death syndrome (2,000 deaths), RSV bronchiolitis (22,000 hospitalisations, 1,100 deaths), acute otitis media (3.4 million outpatient visits), otitis media with effusion (110,000 tympanostomies), asthma (1.8 million outpatient visits, 14 deaths), and fire-related injuries (10,000 outpatient visits, 590 hospitalisations, and 250 deaths). Parental smoking was found to be an important preventable cause of morbidity and mortality among American children it results in annual direct medical expenditures of USD 4.6 billion and loss of life costs of USD 8.2 billion [298(NC)]. 

It is estimated that in the developed world, most deaths are due to two major causes circulatory diseases (heart attacks and strokes) and cancer. A large proportion of these two diseases is attributable to environmental and lifestyle factors including diet, social status, cultural practices, tobacco smoking and alcohol abuse. In recent years health professionals and governments have begun to closely examine ways in which risk factors for these major killer diseases can be modified so as to reduce excess premature mortality from them. 

On Thursday, December 4, 1952, a slow-moving anticyclone came to a halt over the city of London (10). Fog developed over the city, and particulate and sulfur pollution began accumulating in the stagnating air mass. Smoke and sulfur dioxide concentrations built up over the following 3 days. On Monday, the polluted fog began to ease, and by Tuesday conditions were back to normal. Mortality records showed that deaths increased in a pattern very similar to that of the pollution measurements (Fig. 1). It was estimated that 4000 extra deaths were attributable to this pollution episode (11). 

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