Smoking: From 1994, in collaboration with Sir Richard Peto, I led the effort to redesign the South African national death certificate to conform to World Health Organization standards, and introduced questions on smoking. This world-first led to one of the largest studies on tobacco-attributed mortality in the world (N=2m, with 0.2m records updated annually, Sitas et al 2013, 53 cit). The South African death certificate study on smoking was cited in the US Surgeon General’s 50-year report, was recognised in a Lancet commentary as a cost-effective way to monitor the smoking epidemic internationally – (Opie 2013, Jha 2014)- this method has now been copied by the CDC in Tianjin Province, China, and being considered in Cyprus and parts of Mexico (see review-Sitas et al 2018), and recently in Victoria, Australia.
I have made significant contributions in the understanding the extent of the smoking epidemic on cancer in the black population of South Africa showing lung cancer risks of a pack-a-day smokers in that population were the same as those of British doctors (Stein et al 2008 56 cit), and mortality risks of Australian ‘current smokers’ are now the same as those observed in the USA and UK (Banks et al 2015, 157 cit). My survey work on smoking in Swaziland school children and their parents (Prichard 1999) is one of the only two surveys in that country still cited by WHO. My work on smoking cessation after a cancer diagnosis (Sitas et al 2014 43 cit) is now leading to efforts by the State-based NSW Cancer Institute to implement smoking cessation among people diagnosed with cancer in New South Wales. I recently (2018) coordinated a response to the Australian Bureau of Statistics review of 2021 census topics to consider inserting questions on smoking, which is shortlisted. I was an invited member to the WHO-IARC Working Group on Carcinogenicity of Tobacco and Environmental Tobacco Smoke (Vineis 2004, 797 cit), and an invited reviewer on a WHO Knowledge summary on smoking cessation after cancer (2018) I am a member of the Clinical Oncological Society of Australia on smoking cessation in cancer patients, chairing the Efficacy group. I am leading a supplement in Cancer Epidemiology (Elsevier) on tobacco cessation after cancer. My contribution on smoking, COVID and emerging respiratory pandemics in the Bulletin of WHO is leading to a worldwide collaboration of large >100,000 cohort studies using the Richard Doll Consortium.
Relevant reports / papers:
- Li W, Wang D, Zhang H, Zhang Y, Zheng W, Xue X, Shen W, Sitas F, Jiang G. The methodology for assessing smoking-attributed mortality based on All Causes of Death Surveillance in Tianjin, China, 2010-2015. Tob Induc Dis. 2020 Mar 23;18:21. doi: 10.18332/tid/116970.
- Sitas F, Harris Roxas B, Bradshaw D, Lopez A. Smoking and infectious respiratory epidemics. Bull WHO online (in press Jan 2021)
- Sitas F, Bradshaw D, Egger S, Jiang G, Peto R. Smoking counts: experience of implementing questions on smoking on official death certification systems. Int J Epidemiol. 2018 Nov 20. doi: 10.1093/ije/dyy226.
- Sitas F, Weber MF, Egger S, Yap S, Chiew M, O'Connell D. Smoking cessation after cancer. Journal of Clinical Oncology 2014; 32:3593-5. 19 Cit. Showing survival benefits of cessation that are similar to those obtained by radiation therapy
- Banks E, Joshy G, Weber MF, Liu B, Grenfell R, Egger S, Paige E, Lopez AD, Sitas F, Beral V. Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med. 2015; 13(1):281. Cited extensively by Australian policy makers 173 cit
- Sitas F, Egger S, Bradshaw D, Groenewald P, Laubscher R, Kielkowski D, Peto R. Differences among the coloured, white, black, and other South African populations in smoking-attributed mortality at ages 35-74 years: a case-control study of 481,640 deaths. Lancet 2013; 382: 685-93. 31 Cit. (& accompanying editorial and commentary). Showing TB is the leading cause of tobacco related mortality in Africans; Some TB programs now incorporating smoking cessation. Method of adding smoking questions on death certificate now copied by Tianjin CDC, China. 53 cit.
- Vineis P, Alavanja M, Buffler P, Fontham E, Franceschi S, Gao YT, Gupta PC, Hackshaw A, Matos E, Samet J, Sitas F, Smith J, Stayner L, Straif K, Thun MJ, Wichman HE, Wu AH, Zaridze D, Peto R, Doll R. Tobacco and cancer: recent epidemiological evidence. Journal of the National Cancer Institute 2004; 96: 99-106. 804 Cit. Keystone summary of the evidence of carcinogenicity of tobacco.
- Working Group on Evaluation of Carcinogenic Risks to Humans. Vol 83, Tobacco and Environmental Tobacco Smoke. International Agency for Research on Cancer. Lyon, 2002.
- Parkin DM, Ferlay J, Hamdi-Cherif, Sitas F, Thomas J, Wabinga H, Whelan SL. Cancer in Africa: Epidemiology and Prevention. IARC Scientific Publications No. 153, International Agency for Research on Cancer, Lyon, 2003. 254 Cit
- Sitas F Report to VicHealth on Quit Victoria Smoking and Health survey and related issues. CPHCE, UNSW, 27/11/2019
- Sitas F Lopez A. Smoking question on death notification forms in Australia: A proposal. UNSW 2019
- Clinical Oncology Society of Australia Smoking Cessation Working Group. Smoking Cessation in Cancer Patients: Embedding Smoking Cessation Care in Australian Oncology Health Services. Clinical Oncology Society of Australia. August 2020.
Field of Research (FoR)
A/Prof Freddy Sitas has a D Phil in Epidemiology from Oxford University, an MSc in Epidemiology from London School of Hygiene and Tropical Medicine and an MSc (MED) from WITS University, South Africa. He has made a significant contribution in the design and implementation of policy relevant population and clinical infrastructure studies on chronic disease prevention. He has led several collaborations and consortiums and has published...view more
A/Prof Freddy Sitas has a D Phil in Epidemiology from Oxford University, an MSc in Epidemiology from London School of Hygiene and Tropical Medicine and an MSc (MED) from WITS University, South Africa. He has made a significant contribution in the design and implementation of policy relevant population and clinical infrastructure studies on chronic disease prevention. He has led several collaborations and consortiums and has published extensively on the effects of environmental and lifestyle factors such as smoking, BMI, alcohol and infection on cancer and premature mortality. He has worked extensively with cancer, mortality statistics and other large health related datasets. He is Conjoint Professor at the School of Public Health and Community Medicine, UNSW Sydney, Associate Professor, School of Public Health, University of Sydney and Honorary Associate Professor at the Menzies Centre for Health Policy, University of Sydney. His current interests include how the primary care sector can become more involved in prevention of chronic disease.
Membership of external committees
Chair, Efficacy section, Clinical Oncology Society of Australia. Smoking cessation after cancer working Group.
Assistant Editor: Cancer Epidemiology, Elsevier Press
Assistant Editor: International Journal of Epidemiology, Oxford University Press
Editorial Board: Infectious Agents and Cancer (Biomed Central)
Member: Chronic Care Network, Agency for Clinical Innovation (NSW Ministry of Health)
BSc (U. WITS), MSc (Med) (U. WITS), MSc (Epidemiology (London School of Hygiene and Tropical Medicine), D.Phil (Epidemiology) (U. Oxford)
George Oettle Award (2015) for contribution to cancer research
My Research Activities
Using pathology tests to enhance GP/patient conversation around prevention (CPHCE, Charles Perkins Centre, RPA Pathology)
Smoking questions on death notification forms - Analysis of records from South Africa and Tianjin Municipality (MRC South Africa, University of Oxford, CDC Tianjin).
Smoking cessation after cancer; Clinical Oncological Society of Australia policy review
EVOLVING RISK FACTORS FOR CANCERS IN AFRICAN POPULATIONS: Lifestyle, infection, genetic susceptibility and cancer in South Africa:
development of research capacity and an evidence base for cancer control (MRC South Africa, German Cancer Research Centre, Kings College London, MRC AIDS Virus Research Institute, Uganda, National Health Laboratory Service, South Africa)
Hormone replacement Therapy and high risk cervical lesions (Cancer Council NSW, SPHCM UNSW, SPH USyd)
HPV and skin cancer (Cancer Council NSW, USyd, UNSW)
COVID-19 and Smoking.
My Research Supervision
Areas of supervision
Lifestyle modification in primary care
Quantifying benefits of smoking cessation after cancer / serious hospitalisation
COVID and smoking
infectious respiratory disease and smoking
Melitah Mothlale- PhD - WITS University - Epidemiology of Kaposi Sarcoma in South Africa
Mwiza Gideon Singini - PhD - WITS University - seroepidemiology of high risk HPV and detection of cervical cancer