Estimating smoking-attributable mortality in the United States

Area of Science:

• Public Health
• Epidemiology
• Biostatistics

Background:

• Tobacco use is a leading cause of preventable death globally.
• Estimating smoking-attributable deaths is crucial for public health interventions.
• Existing models require updated data for accurate U.S. state-level assessments.

Purpose of the Study:

• To re-estimate the Preston/Glei/Wilmoth model coefficients using recent U.S. state data.
• To calculate smoking-attributable fractions (SAFs) for all U.S. states in 2004.
• To assess smoking's contribution to regional mortality disparities, particularly in southern states.

Main Methods:

• Re-estimation of the Preston/Glei/Wilmoth model using contemporary U.S. mortality and smoking data.
• Calculation of state-specific and national SAFs for the year 2004.
• Comparative analysis of smoking-attributable mortality across U.S. states and regions.

Main Results:

• An estimated 21% of male and 17% of female deaths were attributable to smoking in 2004.
• State-level SAFs varied significantly, ranging from 11% to 30% for men and 7% to 23% for women.
• Smoking-related mortality accounted for up to 60% of the excess adult mortality in southern states.

Conclusions:

• The updated model provides reliable estimates of smoking-attributable mortality for U.S. states.
• Significant state-level variations in smoking's impact highlight the need for tailored public health strategies.
• The findings underscore smoking as a key driver of health inequalities, especially in the southern U.S.