Addiction mortality in the United States 1980: tobacco alcohol and other substances.

The literature on tobacco alcohol heroin cocaine and other drugs was surveyed and titles abstracts and copies of recent relevant articles were obtained in the effort to make an overall estimate of addiction mortality. A printout of US mortality by every cause in 1980 was obtained from the National Center for Health Statistics to facilitate identification of drug-related deaths by discrete categories. Colleagues in government agencies provided pertinent publications and participated in work group discussions of methods and findings. Data from 2 broad-based epidemiological studies of excess mortality from smoking among adult US males during the 1950s and 1960s are presented in tables. These studies indicate that at least 80% of male deaths from lung cancer were attributable to smoking and that total excess mortality among smokers was more than 5 times the number of lung cancer deaths in the combined population of smokers and nonsmokers. Using lung cancer deaths as an index of total deaths from smoking it was estimated that there were approximately 250000 deaths from smoking in the US during 1960 and there were about 300000 such deaths in the US during 1966. Because cardiovascular disease death rates have fallen substantially during the last 15 years while lung cancer death rates have continued to increase the lung cancer index of total excess mortality from smoking must be recalibrated by means of another broad-gauged prospective study of smoking and mortality from smoking during the 1980s. The 3rd major category of excess mortality from smoking is comprised of the noncancerous but life destroying diseases of the respiratory system. Total adult mortality from noncancerous diseases of the respiratory system in 1980 attributable to smoking is estimated to have been about 61000 deaths. Epidemiological studies consistently show higher peptic ulcer disease morbidity and mortality rates for smokers than for nonsmokers. A large proportion of fires in homes and hotels are caused by smoking an estimated 250000 deaths from accidental fires caused by smoking in 1980. It is estimated that the total number of excess deaths in the US in 1980 attributable to smoking cigarettes was approximately 485000. The 100000 deaths ascribed to alcohol in 1980 represent approximately 5% of total US mortality in 1980. It is estimated that US mortality in 1980 attributable to acute overdose probably exceeded 5000 deaths.