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Also, contact your doctor if you experience symptoms such as: [18] Dark urine or small amounts of urine Rapid heart rate Headaches Dizziness Fatigue, irritability, or confusion Severe pain in your abdomen or rectum Tar-like or bloody stools Chronic diarrhea can have a variety of possible causes

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More specifically, the rise in Western Sub-Saharan Africa is possibly due to an underlying rise in incidence trends combined with a more westernized lifestyle and limited access to treatment [1], whereas Central Asia might be explained by an increased prevalence of risk factors associated with globalization and economic development, such as increased consumption of dietary fat and decreased level of physical activity, and significantly increased smoking tobacco use over the past 30 years (eg, in Afghanistan, Saudi Arabia, Uzbekistan, Lebanon) [4, 21]

Thats one of the reasons that WHO uses the term epidemic to describe tobacco-related disease and warns that if current trends continue, it may cause one billion deaths in the 21st century