title: Smoking-attributable mortality in Bangladesh: proportional mortality study.
abstract: OBJECTIVE
  To directly estimate how much smoking contributes to cause-specific mortality in Bangladesh.
  
  
  METHODS
  A case-control study was conducted with surveillance data from Matlab, a rural subdistrict. Cases (n = 2213) and controls (n = 261) were men aged 25 to 69 years who had died between 2003 and 2010 from smoking-related and non-smoking-related causes, respectively. Cause-specific odds ratios (ORs) were calculated for "ever-smokers" versus "never-smokers", with adjustment for education, tobacco chewing status and age. Smoking-attributable deaths among cases, national attributable fractions and cumulative probability of surviving from 25 to 69 years of age among ever-smokers and never-smokers were also calculated.
  
  
  RESULTS
  The fraction of ever-smokers was about 84% among cases and 73% among controls (OR: 1.7; 99% confidence interval, CI: 1.1-2.5). ORs were highest for cancers and lower for respiratory, vascular and other diseases. A dose-response relationship was noted between age at smoking initiation and daily number of cigarettes or bidis smoked and the risk of death. Among 25-year-old Bangladeshi men, 32% of ever-smokers will die before reaching 70 years of age, compared with 19% of never-smokers. In 2010, about 25% of all deaths observed in Bangladeshi men aged 25 to 69 years (i.e. 42,000 deaths) were attributable to smoking.
  
  
  CONCLUSIONS
  Smoking causes about 25% of all deaths in Bangladeshi men aged 25 to 69 years and an average loss of seven years of life per smoker. Without a substantial increase in smoking cessation rates, which are low among Bangladeshi men, smoking-attributable deaths in Bangladesh are likely to increase.
authors.affiliation: Centre for Control of Chronic Diseases, International Centre for Diarrhoeal Disease Research Bangladesh, 68 Shaheed Tajuddin Ahmed Sarani, Mohakhali, Dhaka 1212, Bangladesh .
authors.forename: Dewan S
authors.initials: DS
authors.lastname: Alam
authors.forename: Prabhat
authors.initials: P
authors.lastname: Jha
authors.forename: Chinthanie
authors.initials: C
authors.lastname: Ramasundarahettige
authors.forename: Peter Kim
authors.initials: PK
authors.lastname: Streatfield
authors.forename: Louis W
authors.initials: LW
authors.lastname: Niessen
authors.forename: Muhammad Ashique H
authors.initials: MA
authors.lastname: Chowdhury
authors.forename: Ali T
authors.initials: AT
authors.lastname: Siddiquee
authors.forename: Shyfuddin
authors.initials: S
authors.lastname: Ahmed
authors.forename: Timothy G
authors.initials: TG
authors.lastname: Evans
mesh_terms: D000328:Adult; D000368:Aged; D001459:Bangladesh / Q000453:epidemiology; D002423:Cause of Death / Q000639:trends; D016001:Confidence Intervals; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011159:Population Surveillance; D012189:Retrospective Studies; D012907:Smoking / Q000401:mortality*