Historical and Projected Smoking Related Deaths in the US

Smoking is the largest modifiable behavioral risk factor for cancer.¹ Examining historical trends in overall trends in smoking attributable deaths (SADs) (Figure 2.7.5) allows us to examine the impact of smoking on mortality over time but masks the potential subgroup disparities. Projected trends (Figure 2.7.6) can help us examine the future potential impact of smoking on SADs. As certain groups reduce their risk of smoking-related mortality by quitting smoking, greater disparities could be created if the benefits of policies and cessation are not equally distributed.

Examining state-level cigarette smoking and lung cancer mortality rates suggests similar patterns of geographic disparities based on tobacco use. States with the highest rates of tobacco use and lung cancer mortality cluster in the South and Midwest regions of the United States (Maps 2.7.1 and 2.7.2).

Today’s tobacco-related disease rates reflect historical tobacco use, as mortality and disease incidence lag due to the development of chronic diseases like lung cancer. Although overall tobacco use is reducing, current disparities in use will be reflected in future disease rates, impacting certain groups more, and thus increasing health inequities. Therefore, it is important to intervene to reduce these disparities specifically in addition to an overall decline in tobacco use to prevent long term health consequences (Figure 2.7.7).