The study, “Attributable deaths from smoking in the last 100 years in India”, was published online today in Current Science. It says nearly 4.52 trillion cigarettes and 40.3 trillion bidis have been produced in these 100 years. Smoking kills 1.2 million people annually and India has 111 million smokers.

Conducted by the International Union Against Tuberculosis and Lung Disease, New Delhi, and Healis-Sekhsaria Institute for Public Health, Navi Mumbai, the study finds that the full impact of the smoking epidemic is yet to take place.

“The findings are crucial because even if we are able to completely stop manufacture of cigarettes and bidis from today, due to its production and consumption in the last 100 years, 100 million deaths will occur across India,” said Dr P C Gupta, co-author of the study from Healis-Sekhsaria Institute. “And some of these deaths will continue to occur till the middle of this century. Further, if we don’t act now, the number of premature deaths will increase.”

Between 65.7 to 78.8 million Indians will die in the next 50 years and at least half of those who smoke currently are expected to die prematurely in the next 35 to 40 years, the study says. Given that smoking peaked in the mid-1990s, most deaths in the future, starting 2025-2030, will continue till 2050, it says.

Lead author Pranay Lal, of the International Union Against Tuberculosis and Lung Disease, told The Indian Express that the estimates are alarming even though they were derived from the most conservative data sets. This study calls for epidemiological research and a review of existing tobacco control measures in India.

“There are currently no estimates of mortality, over a period of time, in India that can be directly attributed to cigarettes/bidis manufactured in the country. The objective of this study was to estimate the number of premature deaths that can be attributable to cigarette and bidi manufactured and consumed over the last 100 years in India,” the study says. The study estimated the total numbers of bidis and cigarettes manufactured over the last 100 years and then used the relative risk for mortality derived from the Mumbai cohort study, which associates premature death to smoking.