Abstract

Background The adult smoking prevalence has declined more in California than the rest of the US in the past 2 decades. Further, California has faster declines in cancer mortality, lung cancer incidence and heart disease mortality. However, no study has examined smoking-related cancer mortality between California and the rest of the US.

Methods The smoking-attributable cancer mortality rate (SACMR) from 1979 to 2005 in California and the rest of the US are calculated among men and women 35 years of age or older using the Joinpoint regression model to calculate the SACMR annual percentage change. The SACMR is the sum of the smoking-attributable death rates of 10 smoking-attributable cancers.

Results The SACMR has declined more in California (25.7%) than the rest of the US (8.9%) from 1979 to 2005. California men had a lower SACMR than the rest of the US over the entire study period, with the difference tripling from 7.4% in 1979 to 23.9% in 2005. The difference of female SACMR between California and the rest of the US went from 17.9% higher in 1979 to 13.4% lower in 2005.

Conclusions California's SACMR decrease started 7 years earlier than the rest of the US (1984 vs 1991), and California experienced an accelerated decline of SACMR compared to the rest of the US overall and among men and women from 1979 to 2005. Although the SACMR started declining before the creation of the California Department of Public Health, California Tobacco Control Program, the SACMR rate of decline in California accelerated after the programme's inception.