1549-1676 Zheng, Wei McLerran, Dale F Rolland, Betsy A Fu, Zhenming Boffetta, Paolo He, Jiang Gupta, Prakash Chandra Ramadas, Kunnambath Tsugane, Shoichiro Irie, Fujiko Tamakoshi, Akiko Gao, Yu-Tang Koh, Woon-Puay Shu, Xiao-Ou Ozasa, Kotaro Nishino, Yoshikazu Tsuji, Ichiro Tanaka, Hideo Chen, Chien-Jen Yuan, Jian-Min Ahn, Yoon-Ok Yoo, Keun-Young Ahsan, Habibul Pan, Wen-Harn Qiao, You-Lin Gu, Dongfeng Pednekar, Mangesh Suryakant Sauvaget, Catherine Sawada, Norie Sairenchi, Toshimi Yang, Gong Wang, Renwei Xiang, Yong-Bing Ohishi, Waka Kakizaki, Masako Watanabe, Takashi Oze, Isao You, San-Lin Sugawara, Yumi Butler, Lesley M Kim, Dong-Hyun Park, Sue K Parvez, Faruque Chuang, Shao-Yuan Fan, Jin-Hu Shen, Chen-Yang Chen, Yu Grant, Eric J Lee, Jung Eun Sinha, Rashmi Matsuo, Keitaro Thornquist, Mark Inoue, Manami Feng, Ziding Kang, Daehee Potter, John D Journal Article United States PLoS Med. 2014 Apr 22;11(4):e1001631. doi: 10.1371/journal.pmed.1001631. eCollection 2014 Apr. ; International audience ; BACKGROUND: Tobacco smoking is a major risk factor for many diseases. We sought to quantify the burden of tobacco-smoking-related deaths in Asia, in parts of which men's smoking prevalence is among the world's highest. METHODS AND FINDINGS: We performed pooled analyses of data from 1,049,929 participants in 21 cohorts in Asia to quantify the risks of total and cause-specific mortality associated with tobacco smoking using adjusted hazard ratios and their 95% confidence intervals. We then estimated smoking-related deaths among adults aged >/=45 y in 2004 in Bangladesh, India, mainland China, Japan, Republic of Korea, Singapore, and Taiwan-accounting for approximately 71% of Asia's total population. An approximately 1.44-fold (95% CI = 1.37-1.51) and 1.48-fold (1.38-1.58) elevated risk of death from any cause was found in male and female ever-smokers, respectively. In 2004, active tobacco smoking accounted for approximately 15.8% (95% CI = 14.3%-17.2%) and 3.3% (2.6%-4.0%) of deaths, respectively, in men and women aged >/=45 y in the seven countries/regions combined, with a total number of estimated deaths of approximately 1,575,500 (95% CI = 1,398,000-1,744,700). Among men, approximately 11.4%, 30.5%, and 19.8% of deaths due to cardiovascular diseases, cancer, and respiratory diseases, respectively, were attributable to tobacco smoking. Corresponding proportions for East Asian women were 3.7%, 4.6%, and 1.7%, respectively. The strongest association with tobacco smoking was found for lung cancer: a 3- to 4-fold elevated risk, accounting for 60.5% and 16.7% of lung cancer deaths, respectively, in Asian men and East Asian women aged >/=45 y. CONCLUSIONS: Tobacco smoking is associated with a substantially elevated risk of mortality, accounting for approximately 2 million deaths in adults aged >/=45 y throughout Asia in 2004. It is likely that smoking-related deaths in Asia will continue to rise over the next few decades if no effective smoking control programs are implemented. Please see later in the article for the Editors' Summary.