Decline in smoking accounts for 40% of fall in US male cancer mortality

Around 40% of the fall in the number of deaths from cancer among US men from 1991 to 2003 can be attributed to the decline in smoking, say researchers from the American Cancer Society.

Writing in Tobacco Control (2006;15:345-7), Michael Thun and Ahmedin Jemal, of the society's department of epidemiology and surveillance research, say that around 146 000 men in the United States owe their lives to antismoking efforts. But no such improvement has yet been seen in women, who took up smoking later than men and have been slower to give it up.

The age adjusted cancer mortality in the US population peaked in 1991. From then until 2003, the most recent year for which data are available, mortality fell by 16.1% among men and by 8.4% among women.

“A large number of deaths from lung cancer were avoided because of the decrease in the lung cancer death rate in men during this period … [which] reflects reductions in cigarette smoking that occurred because of anti-smoking messages and other tobacco-control measures implemented since the 1950s,” the authors wrote.

Although smoking causes deaths from other cancers, lung cancer accounts for 80% of all cancer deaths attributable to smoking. And 88% of deaths from lung cancer among men and 72% among women are attributable to smoking, they say.

“The decrease in lung cancer and overall cancer mortality among men began approximately 30 years after the downturn in their smoking rates,” they write. They say that if the prevalence of smoking had remained as it was in the 1960s, when it began to fall, cancer mortality would have continued to rise at the previous rate.

The authors also applied the 1991 death rate from lung cancer in men to US male population figures from 1991 to 2003. They estimated that the decline in smoking prevented 146 000 deaths from lung cancer in men.

Dramatic as these improvements have been, the authors say that antismoking campaigns have only just begun to pay off. A lower prevalence of smoking and a fall in the number of people taking up smoking will probably lead to a decrease in lung cancer among women and fewer deaths from smoking related diseases in future, they say.