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In 1997, the South African death notification form was revised to include questions on the smoking status of the deceased. This study used 481,640 notifications of deaths occurring between 1999 and 2007 to assess smoking-attributed mortality in South Africa.
Methods: A case-control proportional mortality design was used to estimate smoking-associated relative risks and attributable fractions for a number of potentially smoking-related causes of death. Cases: deaths from underlying causes known from other studies to be causally associated with smoking. Controls: deaths from medical conditions expected to be largely unrelated to smoking. The attributable fractions were then used to calculate the annual average number of deaths attributable to smoking in South Africa.