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APPENDIX 16: Memorandum by Professor Sir Richard Peto (TB 44) 

Martin Broughton was not correct in telling the Health Committee last week that the WHO projections of about 10 million deaths a year from tobacco were based only on evidence from white American males. It is true that when in the late 1980s we first produced such estimated we were chiefly using studies from the UK and US, but since then there have been large studies in developing countries that confirm that these projections are appropriate.

Indeed, the largest study of tobacco deaths ever undertaken was done in China: a brief report of it from Nature Medicine (1999; 5: 15-17) is enclosed . . .

With population growth, therefore, tobacco will cause about as many deaths in India as in China over the next few decades, ie an average of about a million a year in the first decade of the 21st century and about two million a year in the third decade. (Interestingly, Indian smokers have substantially higher rates of premature death than non-smokers not only for neoplastic, vascular and chronic respiratory disease, but also for tuberculosis; TB is still a major cause of death in India.)

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