SMOKING killed almost five million people in 2000 -- and three times as many men as women.

More than half were among smokers aged 30 to 69. Head of the University of Queensland school of population health, Professor Alan Lopez, said the finding was part of a five-year study that examined population and mortality data from 14 different regions of the world. "Tobacco kills as many people today in poor countries as it does in rich countries," Prof Lopez said. Smokers at any age have a triple higher death rate than non-smokers. Prof Lopez and a Harvard University colleague attributed a rise in smoking around the world since 1975 to one in 10 deaths among all adults and almost one in five in men. Three out of four smoking deaths in developed countries and more than eight out of 10 in developing countries were men. But Prof Lopez said the death rate among women rose slightly and would continue to because of the tobacco epidemic among women in developed countries. Only about 10 per cent of women in developing nations smoke because it is now considered unacceptable. "Men smoke in much larger numbers than we thought and for longer than we thought," Prof Lopez said. "We are now beginning to see the health effect of that tobacco use for men and most of those 2.4 million deaths in poor countries are men." Prof Lopez said the research, published in the November edition of international journal Tobacco Control, also found tobacco acted in more sinister ways than previously thought. As well as directly causing disease, it magnified background hazards within the population. In Australia, Britain and America, tobacco mainly kills people because of heart attacks and strokes. "Most tobacco deaths are not from lung cancer, but from heart attack and stroke because it magnifies the big background reasons," Prof Lopez said. In China, most tobacco-related deaths are from chronic bronchitis and emphysema. In India, tobacco kills more people through tuberculosis than cancer.

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