Asia In The Throes Of Early Tobacco Epidemic, Researchers Find

Smoking is pervasive and on the rise in Asia, according to an investigation spanning 20 prospective cohort studies from mainland China, Japan, South Korea, Singapore, Taiwan and India.

AsianScientist (Apr. 30, 2019) – Asian countries are in the early stages of a tobacco smoking epidemic, with habits mirroring those of the US from past decades, say an international team of researchers. The findings are published in JAMA Network Open.

Smoking is a known risk factor for a host of diseases, including lung cancer. In the US, the prevalence of smoking peaked in 1964 and has since declined due to greater awareness of the harmful consequences of tobacco smoke.

In the present study, researchers across the globe analyzed 20 prospective cohort studies from mainland China, Japan, South Korea, Singapore, Taiwan and India. This is, to date, the largest investigation in Asian countries of birth cohort-specific and county- or region-specific smoking patterns and their association with deaths.

The researchers classified the birth cohorts by decades, ranging from pre-1910 to 1950 or later. Smoking accounted for 12.5 percent of all-cause mortality in the pre-1920 birth cohort, 21.1 percent in the 1920s cohort and 29.3 percent for the cohort born in 1930 or later. Lung cancer deaths attributable to smoking, which were 56.6 percent among men in the pre-1920s cohort, increased to 68.4 percent for men born in 1930 or later.

The researchers also studied cohorts with more recent data for men and women born in later decades to analyze smoking habits. The rate for men in mainland China who have ever smoked has increased. Among Chinese men born in 1950 or later, 79.4 percent of those living in urban areas had smoked, and 74.3 percent of those in rural areas had.

On the other hand, women in Asia have a much lower rate for smoking. The average percentage of women smokers for all 20 cohort studies was 7.8 percent compared to 65.4 percent for men, said the researchers.

Future deaths are likely to echo the pattern that occurred in the United States as the popularity of smoking increased during and after World War II, which resulted in lung cancer mortality peaking around 1990, said Professor Zheng Wei at the Vanderbilt Epidemiology Center, US, the study’s senior author.

“There is about a 30-year gap or incubation period for mortality [from tobacco smoking] to occur,” said Zheng.

The researchers call for immediate actions to implement comprehensive tobacco control policies in all Asian countries, including raising tobacco taxes, implementing laws for smoke-free areas, banning tobacco advertising, requiring warning labels for tobacco products and providing help with quitting.

The article can be found at: Yang et al. (2019) Tobacco Smoking and Mortality in Asia: A Pooled Meta-analysis.


Source: Vanderbilt University Medical Center; Photo: Pixabay.
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