Death certificates should say whether the deceased smoked cigarettes, researchers have said.
Stating whether a person was a smoker had yielded valuable insights into the South African population and had benefits for public health resources, said the international team.
Recording on a death certificate whether a person smoked could improve the allocation of resources for treating lung conditions and tuberculosis, for example.
South Africa is the only country in the world to routinely record the detail on all death certificates. It takes the form of a simple yes/no box asking if the deceased smoked in the last five years.
But any move to include the information could trigger accusations of victimising smokers - even in death.
Oxford University professor Sir Richard Peto argued that the data would be invaluable. He said: "Death registries around the world should routinely ask whether the dead person was a smoker.
"This would help assess national death rates from smoking and would help countries discover whether deaths from smoking are increasing or decreasing. There will be hundreds of millions of tobacco deaths this century if current smoking patterns continue."
A study funded in part by UK bodies looked at data from 500,000 deaths in South Africa from 1998 and revealed smoking-related diseases killed more than twice as many mixed-race South Africans than in the white population. Tobacco was the cause of one-in-four of all deaths of middle-aged men compared to one-in-six middle aged women.
Prof Lionel Opie of the Cape Town University said: "Even in countries with sophisticated health systems, it should become part of the routine death registration process. This vital question has led to new understanding in South Africa, and could do likewise elsewhere."