Call for death registries to record whether person was a smoker

In collaboration with the Press Association

Leading health researchers are calling for official death registries in all countries to record whether a person who has died was a smoker.

The call comes after the researchers, led by Professor Sir Richard Peto, analysed data from South Africa, the first, and so far the only, country to record smoking on death registration forms.

Their findings, published in The Lancet, revealed large differences in tobacco-related death rate between the white, black and mixed-ancestry population.

It is the first large-scale analysis of smoking-related mortality in any African country.

In the mixed-ancestry population, smoking was found to cause one in every four deaths in middle-aged men, and one in every six deaths in middle-aged women.

In this population, the overall tobacco-related death rate was approximately double that of the white population.

Professor Freddy Sitas, who also worked on the paper, said the analysis also revealed information about how smoking caused death in different populations.

"Our results show that in 1999 - 2007, smoking caused many deaths from cancer and heart disease, but the main way it killed, particularly in the black population, was by increasing mortality from TB and other lung diseases," he said.

While the death rate from smoking in the population was lower than in the white population, the researchers warn that this is likely to change if the large numbers of young black adults who now smoke, continue to do so.

"Death registries around the world should routinely ask whether the dead person was a smoker," said Professor Sir Peto.

"This would help assess national death rates from smoking and would help countries discover whether deaths from smoking are increasing or decreasing."

Alison Cox, Cancer Research UK's head of tobacco policy, supported the call.

"Tobacco killed one hundred million people in the 20th century and is forecast to kill a billion in the 21st century if we don't act," she said.

"The South African example of using death registries to track smoking behaviour should be adopted by other countries. This information puts tobacco directly in the frame as the number one killer, and gives governments ample evidence for taking strong action to do all it can to stop people being lured into this deadly addiction by tobacco industry marketing," she added.

The study was funded by the South African and UK Medical Research Councils, Cancer Research UK, the British Heart Foundation and the New South Wales Cancer Council.

Copyright Press Association 2013


  • Sitas F, Egger S, Bradshaw D, et al. Differences among the coloured, white, black, and other South African populations in smoking-attributed mortality at ages 35–74 years: a case-control study of 481640 deaths. Lancet 2013; 382: 685–93.