
                         Roanoke Times
                 Copyright (c) 1995, Landmark Communications, Inc.

DATE: WEDNESDAY, November 10, 1993                   TAG: 9311100136
SECTION: NATIONAL/INTERNATIONAL                    PAGE: A-1   EDITION: METRO 
SOURCE: Los Angeles Times
DATELINE:                                 LENGTH: Medium

LEADING DEATH CAUSE? TOBACCO, DOCTORS SAY

In a first-of-its-kind examination of death in the United States, government researchers report Wednesday that while heart disease and cancer may be listed as the nation's leading killers, the biggest underlying cause of death is tobacco use.

The authors came to the startling conclusion that nearly half of the 2.148 million deaths in 1990 could have been prevented through behavioral changes, among them stopping smoking, eating healthier food, exercising more, shunning alcohol and practicing safe sex.

But the research, published in today's Journal of the American Medical Association, singled out tobacco as the No. 1 culprit in causing death. It found that smoking contributed to the deaths of 400,000 people in 1990 - more than the deaths caused by drug use, guns, irresponsible sexual behavior and automobile accidents combined.

"People may not realize the extent of which deaths among Americans are preventable," said Dr. J. Michael McGinnis, who heads the Office of Disease Prevention at the U.S. Department of Health and Human Services and is the study's lead author.

McGinnis and his co-author, Dr. William H. Foege of the Carter Presidential Center in Atlanta, examined the major external factors - those that are not genetic but are instead a product of environment - that contribute to death. They looked at circumstances people can control, such as what they eat and drink, as well as those they cannot, such as "microbial agents" - germs that cause tuberculosis and other illnesses - and "toxic agents," including synthetic chemicals and other pollutants.

In examining death certificates from 1990, the researchers looked beyond the diseases and illnesses listed as cause of death to the reasons people may have gotten sick in the first place. They found that smoking contributed to 19 percent of all deaths in the nation, including those from a wide variety of cancers, heart disease, stroke, low birth weight and burns.

Not surprisingly, this finding drew criticism from a spokesman for the Tobacco Institute, who said it was "not reliable" and based on faulty methodology. "I think the statistics have demonstrably more rhetorical than practical value," said the institute's vice president, Walker Merryman.

The study ranked poor diet and lack of exercise as the second leading cause of death. These habits accounted for 300,000 lost lives, the study said, by increasing the incidence of such illnesses as stroke, diabetes and colon cancer. Sedentary lifestyles were responsible for nearly one-quarter of all deaths from chronic diseases.

Misuse of alcohol helped kill 100,000 people, the researchers found, while drug abuse accounted for 20,000 deaths.

by CNB