Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China

Lin, H.H., Murray, M., Cohen, T., Colijn, C. and Ezzati, M., 2008. Effects of smoking and solid-fuel use on COPD, lung cancer, and tuberculosis in China: a time-based, multiple risk factor, modelling study. The Lancet, 372(9648), pp.1473-1483.

  • Tobacco smoking and indoor air pollution from solid-fuel use are primary global risk factors for chronic obstructive pulmonary disease (COPD) and lung cancer.
  • These factors significantly contribute to mortality from these diseases in developing countries.
  • Smoking is an independent risk factor for tuberculosis, exacerbating the spread and severity of the disease.
  • Implementing moderate to complete reductions in smoking and solid-fuel use through tobacco taxation, advertising bans, and fuel pricing could decrease deaths from COPD and lung cancer.
  • Reduction in these risk factors would also significantly decrease tuberculosis incidence by minimizing the duration of infectiousness through effective treatment.
  • These diseases pose substantial economic burdens, particularly in developing countries, due to healthcare costs, reduced labor market participation, and hindered human capital accumulation.
  • The burden is disproportionately higher in low-income or marginalized communities.
  • Programs targeting low-income communities could offer cleaner fuels or stoves, nutritional supplements, and tuberculosis testing coupled with treatment adherence incentives.
  • Tobacco cessation initiatives could be integrated into tuberculosis treatment programs, possibly supported by financial incentives.
  • Revenue from tobacco taxes could subsidize Directly Observed Treatment, Short-course (DOTS), clean energy technologies, and nutrition programs for participating low-income households.

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