AUSTIN, TEXAS (TIP): While many of the dangers of smoking have been well known for some time, new research shows that the consequences may be larger and deadlier than previously thought.

According to the U.S. Surgeon General, 21 different causes of death are attributed to smoking, with some 480,000 deaths in the United States each year. A study co-authored by epidemiologist Brian Carter with the American Cancer Society examined the corollary health impacts even further.

“We identified at least six new causes of death that we think are probably associated with smoking,” Carter said, “and if you look at these as an aggregate, that would add about 60,000 deaths per year to that 480,000 number.”

The additional smoking-related death links include kidney failure, hypertensive heart disease, infections and various respiratory diseases, Carter said. The study looked at data covering about 1 million people from 2000 to 2011 and was published in the New England Journal of Medicine.

The analysis also found an association between smoking and increased mortality rates for breast and prostate cancer, and Carter said the links to these deaths and the others identified should spur more scrutiny.

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“I think researchers really need to look at them in a much more focused manner to see exactly how smoking might cause these diseases,” he said. “If they’re replicated in other more focused studies, I think they need to be incorporated into annual estimates of the number of deaths caused by smoking.”

Current estimates, which don’t take into account the additional health issues outlined in the study, put the number of smoking-related deaths in Texas at 28,000 per year.

The study is online at U.S. data is

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