Reference to 'ageing societies' conjures imageries that differ sharply. In some cases they revolve around nearly bankrupt pension or social security systems, or about families physically and economically overburdened with responsibilities of simultaneously caring for very young children and the very old. In others, they point to societies overloaded with unsatisfied health care demands of the chronically ill, functionally disabled, and the mentally and physically impaired. In yet others, references to ageing evoke rumblings about stagnant economies, sluggish increases in productivity, heavy taxation burdens, conservative ideologies, and dismal mobility prospects for younger generations. As is plain from reviews of the process in general, 1-15 each and every one of these issues, sharing a negative connotation, corresponds to a dimension of the ageing process. In this paper we consider only two dimensions: demographic profile and health status. The demographic dimension consists of conditions related to the relative size, rate of growth, and composition of the elderly population. The health dimension is a function of conditions that influence current and prospective health status of the elderly population and their demand for and actual use of health care.

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Objectives. We estimated smoking-attributable mortality, assessed the impact of past smoking on recent mortality, and computed expected future losses in life expectancy caused by past and current smoking behavior in Latin America and the Caribbean. Methods. We used a regression-based procedure to estimate smoking-attributable mortality and information for 6 countries (Argentina, Brazil, Chile, Cuba, Mexico, and Uruguay) for the years 1980 through 2009 contained in the Latin American Mortality Database (LAMBdA). These countries jointly comprise more than two thirds of the adult population in Latin America and the Caribbean and have the region’s highest rates of smoking prevalence. Results. During the last 10 years, the impact of smoking was equivalent to losses in male (aged ≥ 50 years) life expectancy of about 2 to 6 years. These effects are likely to increase, particularly for females, both in the study countries and in those that joined the epidemic at later dates. Conclusions. Unless innovations in the detection and treatment of chronic diseases are introduced soon, continued gains in adult survival in Latin America and the Caribbean region may slow down considerably.