Smoking will become the single largest cause of death and disability in the world within the next 25 years, according to the first comprehensive, global study of how people die.
Noncommunicable diseases such as cancer, heart disease and diabetes -- often thought to strike primarily the affluent -- already cause more deaths in the developing world than infectious diseases, the five-year study showed.
The study, done by a team headquartered at the Harvard University School of Public Health and released yesterday, found that depression, also associated with affluence, accounts for 10 percent of productive years lost throughout the world.
One of the most bleak outlooks is for residents of the former Soviet empire. Largely as a result of smoking, alcoholism and accidents, men in that region face a 28 percent risk of death between the ages of 15 and 60, the highest risk outside sub-Saharan Africa.
Because of the rapidly changing nature of death, the report argues, international health agencies should focus less on routine vaccination programs and more on research about noncommunicable diseases.
The report is a "historic achievement," said Dr. Barry R. Bloom of the Albert Einstein College of Medicine in New York City. "It shows that the health differences between countries will be narrowed."
About 50 million people died in 1990, the report's base year, more than 55 percent from noncommunicable diseases. That proportion is expected to jumped to 73 percent by 2020.
Worldwide, one out of every three died from either communicable diseases, childbirth or malnutrition. Virtually all of those deaths were in developing regions. One out of every 10 deaths resulted from accidents, wars, suicides and homicides.
By 2020, the report says, car accidents will be the world's fifth leading cause of death and disability as developing nations build more roads and the number of young adults -- those most often killed in traffic mishaps -- increases.
The team found that noncommunicable diseases already were responsible for more deaths than infectious diseases in all areas except India and sub-Saharan Africa. More people die of heart disease than any other cause.
Smoking, because of its impact on heart disease, lung cancer and other disorders, caused 3 million deaths in 1990, researchers calculated. That total will nearly triple to 8.4 million deaths in 2020, the report predicted.
Pub Date: 9/17/96