Singh et al cardiovascular disease (CVD), pulmonary diseases, and cancer, possibly due to rapid changes in diet and lifestyle and increases in tobacco consumption (Singh et al 1997a, 1997b; Yusuf et al 2001a, 2001b; Sachs 2004; WHO 2005). Tobacco consumption is a worldwide cause of CVD, benign obstructive lung diseases, and cancer mortality, especially for lung cancer (Peto et al 1994; Singh et al 1997a, 1997b, 1997c; Kesteloot 2003; INTERHEART 2006). In developed countries (Gupta et al 1980, 1984; Berger and Wynder 1994; Peto et al 1994; Cavelaars et al 1997; Singh et al 1997a, 1997b; Foley et al 2002; Kesteloot 2003; Puska et al 2003; Schiafﬁno et al 2003; Schoenborn et al 2003), it is also known that lower social or educational classes have a higher prevalence of smokers, obesity, alcoholism, and lower intakes of fruits and vegetables and less spare time spent on physical activity. In one study (CDC 2006) conducted between 1997–1998, data on cigarette smoking in adults in the United States showed that white men were smokers less frequently than black men and the reverse was found for white women compared with black women. The prevalence and extent of tobacco consumption are much greater in other developing and developed countries compared with India (Gupta et al 1980, 1984; Berger and Wynder 1994; Peto et al 1994; Cavelaars et al 1997; Singh et al 1997a, 1997b; Foley et al 2002; Kesteloot 2003; Puska et al 2003; Schiafﬁno et al 2003; Schoenborn et al 2003; CDC 2006; Gerber et al 2006; INTERHEART 2006). In an Indian study, tobacco consumption was observed among 27.5% (n = 249) of men and 11.6% (n = 105) of women (Singh et al 1997c). In rural populations, tobacco consumption is more common than in urban areas (Singh et al 1997a, 1997b). Circulatory, pulmonary, and malignant diseases have already become important as a cause of death in most developing economies of the world, and are likely to as- sume greater importance in the near future (Yusuf et al 2001a, 2001b; Sachs 2004; WHO 2005). Mortality due to CVD is declining in developed countries with only small changes in cancer deaths and in deaths among the elderly and women (CDC 2006; Gerber et al 2006). In de- veloped countries, higher social classes as compared with lower social classes experience greater cardiovascular, pulmonary, and cancer mortality, as well as deaths due to all other causes (Kesteloot 2003; CDC 2006; Gerber et al 2006; INTERHEART 2006). In the present study, we report the prevalence of tobacco consumption among decedents due to circulatory and chronic lung diseases and cancers, based on verbal autopsy questionnaire, in an urban population of north India. 178 Subjects and methods The subjects and methods for the present study have been described in detail elsewhere (Singh et al 2002, 2005). In brief, the city of Moradabad is an urban area with a population of 0.641 million residing in 306 streets or 60 wards. Causes of death recorded at the municipal board might not be correct as these are based on certificates issued by the attending doctors, without confirmation by autopsy. We studied the records of 2842 randomly se- lected adult decedents, aged 25–64 years. During the last two years from July 1999 to July 2001, 2222 decedent’s relatives could respond for this study. Of 2222 decedents, 1385 were male and 837 were female. All the families of these 2222 victims were contacted individually to find out the causes of deaths by verbal autopsy questionnaire (Singh et al 2002, 2005). Since autopsy is not possible in many developing countries due to religious consider- ations, WHO has suggested investigating causes of death by detailed questionnaires administered to spouses and concerned doctors. The head of every family was person- ally called after communication with the help of the local accessible doctor in the healthcare region (lane). At least three calls, via letter/telephone and personal contact via lane doctor were made before any subject or family was declared a noncontact or nonreplier, ie, one in the morn- ing, one in the evening around 1700 hrs, and the last one during the weekend. Our team consisted of a scientist, a health worker, and a doctor, who were trained and briefed regarding the details of questionnaires before starting the survey. The case record forms were pretested by the concerned committee in roughly 30 to 60 families. It was found that 10% of the families who came within reach of survey were declared noncontacts or nonresponders as observed in other surveys (Singh et al 1997a, 1997b). We recorded the name, address, and if pos- sible telephone numbers of the spouse, family doctor, and the doctor who treated the decedent at the time of death. Clinical data on age, sex, height, weight, marital status, occupation, education, past medical and family history, history of hyper- tension, diabetes, stroke, heart attack, alcohol intake, drug intake, tobacco intake, lung tuberculosis, bronchitis, asthma, cancer, mental diseases, diarrhea and dysentery, AIDS and renal, liver, brain, CVD, infectious diseases, and accidents, etc, were recorded. These clinical data were based on medi- cal records of the decedent, death certiﬁcate issued by the doctor, interview of the participating doctor, and the family doctor, interview of the spouse and other family members, with the help of a consented questionnaire, to know the cause International Journal of COPD 2007:2(2)