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Excess mortality among cigarette smokers: changes in a 20-year interval
M J Thun1, C A Day-Lally, E E Calle
1Department of Epidemiology and Surveillance, American Cancer Society, Atlanta, GA 30329-4251, USA.
American Journal of Public Health
|September 1, 1995
Summary
Smoking-related premature mortality doubled for women and remained high for men between the 1960s and 1980s. Lung cancer became the leading cause of smoking-attributable death, surpassing heart disease.
Area of Science:
- Epidemiology
- Public Health
- Cardiovascular Disease Research
Background:
- Smoking has long been linked to increased mortality.
- Understanding temporal trends in smoking-specific death rates is crucial for public health interventions.
Purpose of the Study:
- To analyze changes in smoking-specific death rates from the 1960s to the 1980s.
- To compare mortality trends for lung cancer, coronary heart disease, and stroke between smokers and non-smokers over two decades.
Main Methods:
- Utilized data from two large prospective cohort studies (1959-1965 and 1982-1988).
- Measured death rates for major smoking-related diseases in over 200,000 current smokers and 480,000 non-smokers per study.
- Controlled for daily cigarette consumption and years of smoking in analyses.
Main Results:
- Lung cancer death rates significantly increased in both male and female smokers, with a more pronounced rise in women.
- Coronary heart disease and stroke death rates decreased substantially in both smokers and non-smokers.
- The disparity in all-cause mortality between smokers and non-smokers doubled for women, while remaining stable for men.
Conclusions:
- Premature mortality attributable to smoking doubled in women and remained high in men from the 1960s to the 1980s.
- Lung cancer emerged as the primary cause of smoking-attributable death, overtaking coronary heart disease among White middle-class smokers.