News Release

1995-62
September 11, 1995

1994 Health Canada study published in Canadian Journal of Public Health

OTTAWA - A Health Canada study of deaths attributable to smoking in Canada in 1991, published today in the Canadian Journal of Public Health, shows an increase in mortality since 1989. The study used previous surveys and databases to estimate both national and regional rates of mortality due to tobacco use in 1991.

Key findings in the study include:

• female smoking-related deaths are rising faster than those of their male counterparts. The number of smoking deaths among females increased from 9,009 in 1985 to 13,541 in 1991 while the number of deaths among men remained relatively constant throughout this period.
• as a result of the dramatic rise in female smokers in the 1960s and 1970s, it is expected that female smoking-related deaths will continue to rise until the late 1990s, and may reach, or even exceed, those of males.
• moreover, as "baby-boomers" age within the population, it is expected that large numbers of Canadians will continue to die from smoking.
• since 1989, overall smoking-related deaths have increased by 3,051, for a total of 41,408 in 1991, an increase of 8 per cent. Of these increased deaths 2,721 or 89 per cent were females.
• cardiovascular diseases accounted for the majority of the total number of smoking-attributable deaths (16,393), followed by various cancers (16,268);
• 171 of the overall (41,408) smoking-related deaths were in children under one year of age who died as a result of smoking-related causes, such as low birth weight or respiratory conditions.

The estimated deaths in the study are generally the result of smoking patterns in the 1950s and 1960s.

Health Minister Diane Marleau stated that this dramatic rise in female deaths indicates the need to encourage all women to stop smoking, but especially young girls. She said that the report further destroys any myths questioning the dangers of smoking and its potential to kill. According to the Minister, smoking is clearly the number one preventable cause of death and disease in Canada and that is why one of the government's key priorities is to reduce tobacco consumption in Canada and to persuade young Canadians not to smoke.

The study examined smoking-related deaths for current and former smokers by disease category, region and sex. Specific cancers, cardiovascular and respiratory diseases were identified, along with infant mortality, fire deaths from careless smoking and deaths of non-smokers attributed to second-hand smoking.

The report also estimated that 95,028 years of potential life were lost before age 65, and 262,028 years lost before age 75. Cardiovascular diseases accounted for the highest percentage of potential years of life lost (46 per cent).

Detailed information on the study is contained in the attached fact sheet.

Information:
Sylvie Patry
Health Canada
(613) 957-2988

Tobacco Use and Mortality

Background

Health Canada has completed a study on mortality attributable to tobacco use in Canada for 1991. The purpose of the study was to identify deaths occurring in Canada due to tobacco use, by disease category, region of the country, age and sex.

Data Sources

Deaths from 22 adult smoking-related diseases and four paediatric diseases linked with maternal smoking were extracted from the Canadian Mortality Database - Canadian Centre for Health Information, Statistics Canada.

Fire deaths caused by smokers' material were obtained from the 1991 Annual Report of Fire Losses in Canada.

Estimated lung cancer deaths attributable to second-hand smoke were derived from the Wigle, Collishaw, Kirkbride, Mao paper Deaths in Canada from lung cancer due to involuntary smoking (1987).

Current, former and "never" smoker rates were obtained from the 1991 General Social Survey, Cycle 6, Statistics Canada.

Diagnosis-specific relative risks for smoking-related diseases were determined from the Cancer Prevention Study II of the American Cancer Society (1991).

Methodology

The basis for the smoking-related mortality estimates presented in the study are provided from the 1991 Canadian Mortality Data Base and the Cancer Prevention Study II. A number of formulae were developed to estimate: smoking-related deaths, attributable risk for each smoking-related disease and potential years of life lost.

Current smokers were defined as those who reported smoking cigarettes daily as well as occasionally in the 1991 General Social Survey, Cycle 6. Former smokers were those who reported smoking cigarettes daily in the past, but who did not presently smoke. "Never" smokers were those who reported that they have never smoked cigarettes daily.

Total smoking-attributable mortality (SAM) was calculated by adding all adult disease SAM, paediatric disease SAM, fire deaths and second-hand smoking deaths for each region and sex.

Results

The results of this study indicate that in 1991:

• There were an estimated 27,867 male and 13,541 female deaths in Canada attributable to smoking, for a total of 41,408 deaths. This number includes 171 infants under the age of one who died as a result of smoking-related causes.
• Cardiovascular diseases accounted for the greatest number of deaths with 16,393, while cancers accounted for 16,268 deaths and respiratory diseases for 8,157 deaths.
• Of the deaths caused by smoking-related disease, lung cancer accounted for 31 per cent of male deaths and 26 per cent of female deaths; ischemic heart disease (heart attacks) accounted for 25 per cent of male deaths and 20 per cent of female deaths.
• Eighty-five deaths of both sexes occurred as a result of fires caused by careless smoking.
• Total deaths from all causes in Canada amounted to 105,424 males and 90,123 females. The five leading causes of death were:
  • cardiovascular diseases
  • neoplasms (cancers)
  • respiratory diseases
  • accidents and adverse effects
  • diseases of the digestive system
• Twenty-one per cent of these deaths were attributable to smoking.
• Deaths attributable to smoking by region were as follows:
  • Ontario ... 14,493
  • Quebec ... 11,841
  • Prairies ... 5,892
  • B.C. ... 5,248
  • Atlantic ... 3,934

Deaths due to smoking among males 35 years of age or older ranged from 30 per cent in Quebec to 23 per cent in the Prairies. Female deaths due to smoking ranged from 17 per cent in both B.C. and Quebec and averaged 14 per cent in the remaining regions.

Potential years of life lost due to smoking before age 65 were estimated to account for 95,028 potential years; before age 75, an estimated 262,028 potential years of life were lost. Smoking-related cardiovascular diseases accounted for 46 per cent of potential years of life lost before age 65, and cancers accounted for 45 per cent of lost years before age 75.

The deaths reported in the study were generally the result of smoking habits which began in the 1950s and 1960s.

Conclusions

Smoking remains the number one preventable cause of death and disease in Canada. In 1991, smoking-related deaths accounted for about 62 per cent of the overall increase in deaths from 1989.

Female smoking-related deaths are rising faster than those of their male counterparts. The number of smoking deaths among women increased from 9,009 in 1985 to 13,541 in 1991. The number of deaths among men remained relatively constant throughout this period.

As a result of the dramatic rise in female smokers in the 1960s and 1970s, it is expected that female smoking-related deaths will continue to rise until the late 1990s, and may reach, or even exceed, male levels. Moreover, as "baby-boomers" age within the population, it is expected that large numbers of Canadians will continue to die from smoking.