Abstract
MAIN OBJECTIVE: To document and assess the current health impact of non-neoplastic lung disease (NNLD) in Canadian men and women that is attributable to smoking.DESIGN: Comparison of three recent studies providing estimates of smoking-attributable deaths, potential years of life lost, hospital separations and hospital days due to NNLD in Canada. Review of recent epidemiological studies providing relative risk estimates of smoking-attributable mortality and morbidity for chronic obstructive pulmonary disease and pneumonia, including a meta-analysis.MAIN RESULTS: Each year at least 6700 Canadian men and women die from NNLD attributable to smoking. Smoking-attributable NNLD deaths in men outnumber those in women by about 2 to 1. The majority of these deaths are due to chronic obstructive pulmonary disease, which is exceeded in importance as a smoking-attributable cause of death only by lung cancer and ischemic heart disease. NNLD accounts for about 20% of all smoking-attributable deaths in Canada, 14% of the potential years of life lost due to smoking, and 22% and 25% of all smoking-attributable hospital separations and hospital days, respectively. Long term follow-up assessments of large cohorts suggest that the impact of smoking on health has been underestimated. Recent studies also suggest that women may be more susceptible than men to the adverse effects of smoking on lung function.CONCLUSION: NNLD caused by smoking has an important health impact in Canada. Tobacco control strategies must be enhanced.