The Global Burden of Tobacco Use: A Review of Methods and Recent Estimates
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- Khanna, G. & Stevens, G. Curr Cardio Risk Rep (2011) 5: 96. doi:10.1007/s12170-010-0146-0
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Tobacco use is a risk factor for cardiovascular, cancer, and respiratory mortality. To determine deaths attributable to tobacco, the smoking impact ratio (SIR) method is used, which measures the accumulated hazards of smoking by calculating the excess lung cancer mortality in a population, compared to lung cancer mortality in a non-smoking population. This is done to account for cross-population differences in smoking intensity and duration. Studies using SIR have also generally used relative risks of smoking-related diseases derived from the American Cancer Society’s Cancer Prevention Study to estimate the proportion of the disease attributable to tobacco use. The SIR method, while important for populations lacking high-quality epidemiological studies of the hazards of tobacco use, is still an imperfect method. Recent studies in countries such as India, China, and South Africa have estimated population-specific relative risks from reported tobacco use.