Smoking patterns in Africans and Indians of natal

A high lung cancer rate for African males and a lower rate for Indian males of Durban, Natal, indicated that a study of smoking patterns in Africans and Indians of this region was required. In Part A, a comparison, in African males, of the smoking habits of 45 lung cancer patients and 90 non‐cancerous patients shows that there is a close association between lung cancer and the amount and duration of smoking in this group. In Part B, a comparison between 236 African male patients and 130 Indian male patients who did not suffer from cancer indicates that Africans start smoking at an earlier age than Indians, and that the use of home‐rolled cigarettes is more frequent among Africans than among Indians. While a comparison of smoking patterns between younger males indicates that the younger Indian is a heavier smoker than the younger African, a comparison between older males shows that the older Indian male is not a heavy smoker, whereas the older African male is. These differences between Africans and Indians might account for the higher lung cancer incidence in Africans at present. The greater consumption of tobacco by younger males of both groups than by older males suggests that the incidence of lung cancer may rise in the future. This prediction is based on the assumption that the smoking patterns emerging from this survey reflect the smoking habits of the general population and that the trend towards heavier smoking in younger males will continue. Brief consideration of other factors, such as exposure to occupational carcinogens, pulmonary scarring and domestic air pollution, appears to indicate that Africans are more at risk than Indians for all factors.