Smoking and health in South Africa.

In 1984 smoking rates among adults in South Africa were highest in coloureds (41.1%), followed by whites (34.9%), Asians (29.0%), and blacks (27.7%). With increased urbanisation, income, and education, black and coloured smoking rates are likely to rise. Current trends suggest that the proportion of smoking-related disease mortality and morbidity among coloureds and blacks will increase. Studies in South Africa and elsewhere have shown that smokers run an increased risk of coronary artery disease, lung, oesophageal, and cervical cancer, respiratory disease, gastrointestinal ulcers, and leukoedema. Non-smokers exposed to 'involuntary smoking' are also at risk, and smokeless tobacco is not a safe alternative to smoking. The evidence for smoking-induced health damage is so compelling that action against smoking is urgently needed. Surveys of smoking habits among specific groups show the importance of peer and role model example, and suggest guidelines for the targeting of health education.