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How much of the decrease in cancer death rates in the United States is attributable to reductions in tobacco smoking?

Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, Georgia, USA

Correspondence to:
Michael J Thun
MD, Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30229-4251, USA; mthun@cancer.org

Keywords: attributable mortality; cancer; smoking; tobacco

The first 150 words of the full text of this article appear below.

It is difficult to quantify the benefits of large scale, preventive interventions taken in the past, because the size of the benefit depends on assumptions about what might have happened had there been no intervention. For example, if one wishes to measure how much of the decrease in cancer death rates in the United States is attributable to reductions in tobacco smoking, the most conservative approach is to consider only the time period during which cancer death rates actually decreased. This limits consideration to the observed decrease in overall cancer death rates that occurred among men (but not women) between 1991, the year when the age standardised cancer death rate peaked in the overall US population, and 2003, the most recent year for which final mortality data are currently available.¹ While it seems prudent to base the estimate only on observed data and only during the time period . . . [Full text of this article]

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