Chapter 15: Impact of Tobacco Control on Lung Cancer Mortality in the United States Over the Period 1975–2000—Summary and Limitations

Background: A consortium of six research groups estimated the impact on lung cancer mortality of changes in smoking behavior that began around the publication of the Surgeon General's report (SGR). This chapter presents the results of that effort. We quantified the cumulative impact of changes in smoking behaviors on lung cancer mortality in the United States over the period 1975–2000. Methods: The six groups used common inputs and independent models to estimate the number of U.S. lung cancer deaths averted over the period 1975–2000 as a result of changes in smoking behavior beginning in the mid fifties, and the number of deaths that could have been averted if tobacco control had completely eliminated all smoking following issuance of the first SGR on Smoking and Health in 1964. Results: Approximately 795,000 deaths (550,000 men and 245,000 women) were averted over the period 1975–2000 as a result of changes in smoking behavior since in 1950s. In the year 2000 alone approximately 70,000 lung cancer deaths were averted (44,000 among men and 26,000 among women). However, these represent approximately 30% of lung cancer deaths that could have potentially been averted over the period 1975–2000 if smoking was eliminated completely. In the 10‐year period 1991–2000, this fraction increased to about 37%. Conclusions: Our results show the substantial impact of changes in smoking behavior since the 1950s. Despite a major impact of changing smoking behaviors, tobacco control effort are still needed to further reduce the burden of this disease.

[1]  R. Doll,et al.  Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and lifelong non-smokers. , 1978, Journal of epidemiology and community health.

[2]  S H Moolgavkar,et al.  Mutation and cancer: a model for human carcinogenesis. , 1981, Journal of the National Cancer Institute.

[3]  T. Holford,et al.  Time period compared to birth cohort in Connecticut incidence rates for twenty-five malignant neoplasms. , 1985, Journal of the National Cancer Institute.

[4]  石黒 真木夫,et al.  Akaike information criterion statistics , 1986 .

[5]  S. Gruber Cancer Risk and Incidence Trends: The Connecticut Perspective , 1988, The Yale Journal of Biology and Medicine.

[6]  T R Holford,et al.  Time trend and the age‐period‐cohort effect on the incidence of histologic types of lung cancer in connecticut, 1960‐1989 , 1994, Cancer.

[7]  A Charloux,et al.  The increasing incidence of lung adenocarcinoma: reality or artefact? A review of the epidemiology of lung adenocarcinoma. , 1997, International journal of epidemiology.

[8]  J. Fraumeni,et al.  Cancer surveillance series: changing geographic patterns of lung cancer mortality in the United States, 1950 through 1994. , 1999, Journal of the National Cancer Institute.

[9]  Michael J Thun,et al.  Lung cancer mortality in relation to age, duration of smoking, and daily cigarette consumption: results from Cancer Prevention Study II. , 2003, Cancer research.

[10]  B Rachet,et al.  A flexible modeling approach to estimating the component effects of smoking behavior on lung cancer. , 2004, Journal of clinical epidemiology.

[11]  M. Thun,et al.  Lung cancer mortality is related to age in addition to duration and intensity of cigarette smoking: an analysis of CPS-I data. , 2004, Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology.

[12]  Sang Min Park,et al.  Relative and Absolute Risks of Cigarette Smoking on Major Histologic Types of Lung Cancer in Korean Men , 2005, Cancer Epidemiology Biomarkers & Prevention.

[13]  Mark S. Clements,et al.  Multistage Carcinogenesis and Lung Cancer Mortality in Three Cohorts , 2005, Cancer Epidemiology Biomarkers & Prevention.

[14]  A. Jemal,et al.  How much of the decrease in cancer death rates in the United States is attributable to reductions in tobacco smoking? , 2006, Tobacco Control.

[15]  Fan Chen,et al.  Time Trend and Geographic Patterns of Lung Adenocarcinoma in the United States, 1973-2002 , 2007, Cancer Epidemiology Biomarkers & Prevention.

[16]  Rafael Meza,et al.  Analysis of lung cancer incidence in the nurses’ health and the health professionals’ follow-up studies using a multistage carcinogenesis model , 2008, Cancer Causes & Control.

[17]  Stacey A. Kenfield,et al.  Smoking and smoking cessation in relation to mortality in women. , 2008, JAMA.

[18]  E. Feuer,et al.  Impact of Reduced Tobacco Smoking on Lung Cancer Mortality in the United States During 1975–2000 , 2012, Journal of the National Cancer Institute.