Over 25% Of All US Cancer Deaths Due to Smoking

MedicalResearch.com Interview with:

Joannie Lortet-Tieulent MSc Senior Epidemiologist American Cancer Society, Inc.

Joannie Lortet-Tieulent

Joannie Lortet-Tieulent MSc
Senior Epidemiologist
American Cancer Society, Inc.
Atlanta, GA 30303

MedicalResearch.com: What is the background for this study?

Response: Many tobacco control policies are decided at state level. We have known for some times that some states have pioneered tobacco control, or have implemented strong tobacco control or programs. Meanwhile, in other states, tobacco control and programs can be weaker. Also, some states have large populations with low socioeconomic status, among which smoking prevalence is higher. We were interested in how those state-level differences impact people’s health.

MedicalResearch.com: What are the main findings?

Response: The main findings are that at least 167,000 cancer deaths in the United States in 2014 were attributable to smoking; that is 28.6% of all cancer deaths. Among men, the proportion of cancer deaths attributable to smoking ranged from a low of 21.8% in Utah to a high of 39.5% in Arkansas, but was ≥30% in every state except Utah. Among women, the proportion ranged from 11.1% in Utah to 29.0% in Kentucky and was ≥20% in all states except Utah, California, and Hawaii. Nine of the top ten ranked states for men and six of the top ten states for women were located in the South. In men, smoking explained nearly 40% of cancer deaths in the top five ranked states (Arkansas, Louisiana, Tennessee, West Virginia, and Kentucky). In women, smoking explained more than 26% of all cancer deaths in the top five ranked states, which included three Southern states (Kentucky, Arkansas and Tennessee), and two Western states (Alaska and Nevada).

MedicalResearch.com: What should readers take away from your report?

Response: Smoking still accounts for a substantial proportion of cancer deaths in the United States and the need for strengthening existing tobacco control state and federal programs to promote cessation and discourage initiation.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Some states are applying innovative laws to decrease smoking prevalence (for example, following California and smaller localities, Hawaii has just raised legal age for buying cigarettes to 21 years old). This measure aims at discouraging smoking initiation, thereby increasing the prevalence of never smokers. It would be interesting to examine changes in initiation of smoking in these states vs other states.

MedicalResearch.com: Is there anything else you would like to add?

Response: The United States have a large population and quality data on cancer mortality and smoking prevalence are available. This setting provides a natural experiment to study the impact of state features (such as tobacco control and population demographics) on smoking-related health outcomes. The results of this study can be used as a reference for other countries.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.


State-Level Cancer Mortality Attributable to Cigarette Smoking in the United States
Joannie Lortet-Tieulent, MSc1; Ann Goding Sauer, MSPH1; Rebecca L. Siegel, MPH1; et al
JAMA Intern Med. Published online October 24, 2016. doi:10.1001/jamainternmed.2016.6530

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