Trends for the Impact of Cigarette Smoking on Mortality in US States

Mortality and smoking rates vary over time across the US. The Cancer Intervention and Surveillance Modeling Network-Lung Working Group (CISNET-LWG) has developed a smoking history generator to describe the effects smoking on health. This work further refines these parameters and quantifies effects on life expectancy.

Data from the National Health Interview Survey (NHIS) and the Tobacco Use Supplement to the Current Population Survey (TUS-CPS) were used to estimate smoking history parameters for each state. The age-period-cohort was used in most cases, but an age-cohort mode was used for cessation probabilities. Population mortality data were used to estimate mortality rates for all causes, lung cancer, and non-lung cancer. These were partitioned by smoking status.

California and Kentucky are states with more or less aggressive tobacco control. The difference between population cohort life expectancy and life expectancy of never smoker was greater for males than for females, and it was greater in Kentucky than California because of higher smoking rates. These differences decreased with time. Similar result are shown for each state.

Variation in smoking parameters and mortality trends vary considerably among states. These show variation in exposure to tobacco smoking and their effects on life expectancy. The Southeast region tends to have greater differences from never smokers because of higher smoking rates. However, there are also other factors affecting mortality rates.