Smoking Rarely Cited As Cause of Death on Death Certificates

Even in lung cancer and COPD cases with strong link to smoking, few mentions in part II

WEDNESDAY, Oct. 26 (HealthDay News) -- Doctors rarely cite smoking as the cause of death (COD) on death certificates, even in cases where there is a strong causal link to smoking, according to a study published online Oct. 24 in the Journal of Clinical Pathology.

Ian Proctor, Ph.D., from University College London, and colleagues investigated the frequency with which smoking was cited as a COD on death certificates. A total of 2,128 death certificates and 236 postmortem reports issued at a large teaching hospital between 2003 and 2009 were retrospectively reviewed.

The investigators found that only two death certificates had smoking cited as a COD (0.1 percent), and in 10 cases, smoking was included in part II of the death certificate (0.5 percent). The two cases for which smoking was cited as the COD were lung cancer and chronic obstructive pulmonary disease (COPD). The diagnoses of lung cancer and COPD were included in 279 death certificates, and in most of these cases the deceased was a current or former smoker. No postmortem report cited smoking as causing or contributing to death. In contrast, alcohol was cited in part I of 57.4 percent of death certificates, which included diagnoses linked to alcohol use.

"By not recording smoking on death certificates, doctors are failing to gather important epidemiological and pathological data," the authors write.

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