Medical researchers have released a study that says one million people in India will die every year in the next decade from tobacco-related illnesses. Steve Herman in New Delhi reports the study's authors also made what they call a surprising discovery about the leading fatal illnesses among smokers in India.

In what is the largest-to-date study of smoking and death in India, researchers have concluded that smokers here are putting themselves at even greater risk than previously believed.

The report finds that 70 percent of all smoking deaths in India happen between the ages of 30 and 69, despite the fact that Indians start smoking later in life and smoke less compared to tobacco users in other countries.

The study's results were published Thursday in the New England Journal of Medicine. Researchers also investigated the diseases that kill smokers here. In Western countries, cigarette smokers tend to die of cancer, heart attacks and respiratory diseases. But one of the lead authors of the study, Dr. Prabhat Jha, says the situation is different in the two Asian countries with the most smokers.

"In China it would be much less heart attacks but a lot more respiratory disease and lung cancer," he said. "In India, in urban areas it's mostly heart attacks. In rural areas it's mostly tuberculosis. So that is a surprise."

India is also unique in that most smokers prefer a cheaper, filter-less cigarette known as bidis, which contain ebony tree leaves and less tobacco than commercially-produced cigarettes.

But the study found that even smoking one bidi or cigarette a day significantly raises the risk of death for Indians compared to their non-smoking compatriots.

In Western countries, and China, as well, progress has been made in getting smokers to quit. But Dr. Jha, of the Center for Global Health Research in Toronto, says only two percent of adult smokers in India have kicked the habit.

"Where quitting has become common, death rates do come down," he said. "And that, so far, has mainly been confined to Western countries. China is showing some promise but India is way behind."

It is estimated that India has about 120 million smokers and the study says from the year 2010, one million of them will die every year due to tobacco.

The Indian study was conducted over five years by American, Canadian and Indian researchers and was funded by government health institutes of those three countries.

While India has tightened restrictions on public smoking and advertising of tobacco products, enforcement has been lax.

Reacting to the new study, India's health minister, Dr. Anbumani Ramadoss, says its finding will be studied "very seriously." The minister also says India's Tobacco Regulatory Authority will be strengthened so it can better enforce existing laws.