A book and website all IJE readers should know about

Forey B, Hamling J, Lee P, Wald N. International smoking statistics (2nd edition). A collection of historical data from 30 economically developed countries. Wolfson Institute of Preventive Medicine, Oxford: Oxford Medical Publications, 2002, pp. 854. £110.

Debbie A Lawlor

University of Bristol

IMASS. International Mortality And Smoking Statistics database. CD-ROM. PN Lee Statistics & Computing Ltd. Available from http://www.pnlee.co.uk/free

I think ‘routine data’ are very important for epidemiology, but are in general under-valued and under-utilised. Their particular advantages are that they usually include large numbers, sometimes covering whole populations, and are readily available. If a particular research question can be answered using routinely available data then clearly it should be. One reason why this might not always happen, is that researchers may not be aware of what are available. That is why I am really pleased to be able to review (promote, advertise, make all IJE readers aware of) this book and its associated electronic database. I have frequently used data from the first edition of this book, for both research and teaching purposes. The second edition is a welcome update, and the CD rom, which is regularly updated, makes the data particularly easily accessible and removes one of the limitations of using routine data—that of manually (risking possible errors) abstracting data from paper sources onto electronic formats.

The ‘International Smoking Statistics’ book contains data on smoking prevalence and consumption for 30 ‘economically developed’ countries for years up to 1995 (the first edition contained similar data for 22 countries up to 1985). Data are obtained from two main sources: tobacco sales and national surveys – though data from sub-national sources are included in some tables where suitable national data are not available. Some additional smoking-related data, for example tar content, are also available for some countries. For some countries these data cover time periods from the late 1800s, but for most countries data from the 1940s are presented. The first section of the book provides full details of the methods used to obtain the data. Thirty chapters then cover each country in alphabetic order from Australia through to Yugoslavia. The book isn't a riveting bed-time read, it is an amazingly comprehensive set of useful data. Importantly full details of data sources and possible limitations of these are presented for each country at the end of each chapter, and a full reference list is provided.

The IMASS CD summarizes much of the data from the book in electronic form in Excel spreadsheets, and in addition provides mortality data. Survey-based data on the CD are in the standardized 5-year age group by 5-year time period form derived from the raw survey data as described in Supplement 1 to the book, which is also available on the CD. The mortality data were obtained from the WHO mortality data available on the World Wide Web and includes data on four smoking-related causes of death (lung cancer, coronary heart disease, chronic obstructive pulmonary disease, and non-acute respiratory disease) for each of the 30 countries. The CD includes a detailed user guide. Rather than simply providing a series of Excel spreadsheets the data are linked by Excel programs which allow the user, by pressing a series of buttons, to produce various graphs: mortality plots, consumption plots, prevalence plots, scatter plots (of mortality against prevalence or consumption) and combination plots (simultaneously plotting consumption and mortality using different y axes on the same x axes).

Figures 1 and 2 are examples of the kind of thing that can be produced in a matter of minutes. Figure 1 shows smoking prevalence among UK men for the period 1961–1995 by age group. Importantly, it can be seen that among young men (aged 15–34) smoking prevalence has remained static or slightly increased since 1981 and that 20–24 year olds have now become the most prevalent smokers. A similar plot for UK women (not shown) illustrates a more mixed picture with prevalences decreasing, even in recent years, in most age groups though with the greatest declines seen for middle-aged women. Young women (20–24 years) have been the most prevalent smokers, compared with other age groups, since 1971. Figure 2 shows similar data for men from the former USSR. Smoking prevalence among these men increased from the 1980s for most age groups. These data are only available up to the period 1986–1990 because the Soviet Union ceased to exist after this period. There are some smoking data for the specific republics that previously made up the USSR in the ISS book but these are not included on the IMASS disc.



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Figure 1 Smoking prevalence among UK men for the period 1961–1995 by age group

 


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Figure 2 Smoking prevalence among men from the former USSR for the period 1961–1995 by age group

 
Importantly the electronic IMASS data are freely available from the web-site: http://www.pnlee.co.uk/. Once a user has registered they will also be sent email information of regular updates. All that is required of users is that they acknowledge their source when using the data for teaching or research. For using the electronic data, having experience of Excel is an advantage (but the supporting information and programmed system is straightforward), and compared with some electronic programs the manipulations can sometimes feel slow (but are clearly much much quicker than trying to obtain the data first hand). At the moment making cross-country comparisons is not easy since this involves opening all of the country data sets and my computer (which is new and fairly powerful) could not get beyond 15 countries before crashing. However, future updates are planned to remedy this by using a program that will only require opening one country's data at a time, and then extracting and storing the necessary data before moving on to the next country's dataset.

The data enables one to look at smoking and mortality patterns by gender, age, birth cohort, and country, but data stratified by other characteristics such as socioeconomic position are not provided. Although many of the surveys used to compile these data will include other such characteristics there is no intention, currently, to include these in the IMASS program. Future updates may, however, provide a list of other characteristics in each of the surveys used to assemble these data.

In summary, this is a great resource that many IJE readers will find useful—if you haven't already, then you should be logging onto the IMASS web-site now!





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