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Global Smoking Death Tolls Shift [09/12-1]

Excerpts from: Smoking's Global Death Toll Shows Shift

Newsday.Com [09/11/03]

The global death toll from smoking is shifting dramatically, with about as many people now dying from smoking in the developing world as in industrialized nations, according to the most thorough estimate to date.

The research, published this week in The Lancet medical journal, concludes that 4.84 million people died from smoking worldwide in 2000 -- 2.41 million in developing countries and 2.43 million in rich nations.

Experts say the study will likely spur governments -- especially those in developing countries -- to pursue anti-smoking health policies.

Experts have previously estimated tobacco death trends in the industrialized world, where smoking first became prevalent, but evidence from poorer countries has been thin.

The World Health Organization estimated in 1990 that about 3 million people die every year from smoking worldwide, but that was a crude extrapolation of trends in the Western world. Much more has been learned since then about how smoking affects different populations.

A major study in 2001 of smoking patterns in China showed that, unlike in the West, tobacco causes many more deaths there from chronic lung disease than from lung cancer.

A study last month found that in India, smoking mainly kills through tuberculosis rather than lung cancer as in the West.

The so-called Framework Convention on Tobacco Control calls for a general ban on tobacco advertising and promotion -- or restrictions in countries where, as in the United States, a total prohibition would violate the constitution.

The treaty says health warnings -- including pictures such as diseased gums and lungs -- should cover at least half the package. In particular it aims to stop hard-sell tactics aimed at adolescents and strip tobacco of its image of being glamorous and cool.

The accord takes effect after 40 countries have ratified it. Much work lies ahead in trying to put the terms of the convention into practice, especially in developing countries, where 70 percent of the 10 million deaths forecast in 2030 will occur.

Developing countries, already grappling with a heavy burden from infectious diseases, have been at the fore in pushing for the convention, saying they need protection from tobacco multinationals who have switched their sales drives from saturated Western markets to Asia and Africa.

There are about 1 billion smokers worldwide.


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