Abstract
Objective: The California tobacco control program enacted in 1988 has been associated with declines in smoking and heart disease mortality. Since smoking also causes lung cancer, we investigated whether the program was associated with a decline in lung and other cancer incidence.
Methods: Age-adjusted incidence rates of lung and bladder cancer (which are caused by smoking) and prostate and brain cancer (which are not) in the San Francisco-Oakland (SFO) Surveillance Epidemiology End Results (SEER) registry and other eight SEER registries from 1975 to 1999 were fitted in multiple regression analyses accounting for the time lag between program implementation and its effects on cancer incidence. Cigarette consumption over time was also analyzed and related to lung cancer incidence.
Results: With a one year lag, the incidence of lung cancer in SFO, relative to eight other SEER registries, fell significantly below that predicted from the pre-1990 rates, by −0.981 (cases/100,000/year)/year (p= 0.001). With a three year lag, the incidence of bladder cancer fell by −0.234 (cases/100,000/year)/year (p= 0.066). No association of the program was observed on prostate or brain cancers in SFO. During the first decade, the Program was associated with about a 6% reduction in lung cancer incidence; state-wide that corresponds to about 11,000 cases avoided.
Conclusion: A comprehensive tobacco control program is associated with a lower incidence of lung cancer.
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References
Glantz SA, Balback E (2000) Tobacco War: Inside the California Battles. Berkeley: University of California.
Bal DG, Kizer KW, Felten PG, Mozar HN, Niemeyer D (1990) Reducing tobacco consumption in California. Development of a statewide anti-tobacco use campaign. Jama 264(12): 1570–1574.
Pierce JP, Gilpin EA, Emery SL, et al. (1998) Has the California tobacco control program reduced smoking? Jama 280(10): 893–899.
Lightwood JM, Glantz SA (1997) Short-term economic and health benefits of smoking cessation: myocardial infarction and stroke. Circulation 96(4): 1089–1096.
Fichtenberg CM, Glantz SA (2000) Association of the California Tobacco Control Program with declines in cigarette consumption and mortality from heart disease. N Engl J Med 343(24): 1772–1777.
Fichtenberg CM, Glantz SA (2001) Controlling tobacco use. N Engl J Med 344: 1798–1799.
American Cancer Society (2001) Cancer Facts & Figures 2001. Report. Atlanta, GA: ACS.
Thun MJ, Henley SJ, Calle EE (2002) Tobacco use and cancer: an epidemiologic perspective for geneticists. Oncogene 21(48): 7307–7325.
Alberg AJ, Samet JM (2003) Epidemiology of Lung Cancer. Chest 123(90010): 21S–S49.
Jemal A, Cokkinides VE, Shafey O, Thun MJ (2003) Lung cancer trends in young adults: an early indicator of progress in tobacco control (United States). Cancer Causes Control 14: 579–585.
Centers for Disease Control and Prevention (2000) Declines in Lung Cancer Rates–California, 1988-1997. MMWR Weekly Mortality Rep 49(47): 1066–1069.
Scott L, Cowling D, Schumacher J, Kwong S, Hoegh H. Tobacco and Cancer in California, 1988–1999 (2003 August) Sacramento, CA: California Department of Health Services, Cancer Surveillance Section.
USDHHS. The Health Consequences of Smoking: Cancer. A report of the Surgeon General: U.S. Department of Health and Human Services, Public Health Service, Office on Smoking and Health; 1982. Report No.: DHHS Publication Number (PHS) 82-50179.
Levi F, La Vecchia C (2001) Tobacco smoking and prostate cancer: time for an appraisal. Ann Oncol 12(6): 733–738.
Lotufo PA, Lee IM, Ajani UA, Hennekens CH, Manson JE (2000) Cigarette smoking and risk of prostate cancer in the physicians' health study (United States). Int J Cancer 87(1): 141–144.
Zheng T, Cantor KP, Zhang Y, Chiu BC, Lynch CF (2001) Risk of brain glioma not associated with cigarette smoking or use of other tobacco products in Iowa. Cancer Epidemiol Biomarkers Prev 10(4): 413–414.
Ries L, Eisner M, Kosary C, et al. (2002) SEER Cancer Statistics Review, 1973–1999. Bethesda, MD: National Cancer Institute.
Orzechowski and Walker, eds. (2001) The Tax Burden on Tobacco. Arlington, Virginia.
Eberhardt M, Ingram D, Makuc D, et al. (2001) Urban and Rural Health Chartbook. Health, United States, 2001. Hyattsville, Maryland: National Center for Health Statistics.
Center for Health Statistics (1999) Heart disease deaths, California 1997. Sacramento: California: California Department of Health Services. Report No.: DS99-09001.
Aguirre-Molina M, Molina CW, Enid Zambrana R, eds. (2001) Health Issues in the Latino Community. San Francisco: Jossey-Bass.
USDHHS. (1990) The Health Benefits of Smoking Cessation: A Report of the Surgeon General, 1990. U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic disease Prevention and Health Promotion, Office on Smoking and Health. Report No.: DHHS Publication No. (CDC) 90–8416.
Burns DM (2000) Primary prevention, smoking, and smoking cessation: implications for future trends in lung cancer prevention. Cancer 89(11 Suppl): 2506–2509.
Speizer FE, Colditz GA, Hunter DJ, Rosner B, Hennekens C (1999) Prospective study of smoking, antioxidant intake, and lung cancer in middle-aged women (USA). Cancer Causes Control 10(5): 475–482.
Ebbert JO, Yang P, Vachon CM, et al. (2003) Lung cancer risk reduction after smoking cessation: observations from a prospective cohort of women. J Clin Oncol 21(5): 921–926.
Brown CC, Chu KC (1987) Use of multistage models to infer stage affected by carcinogenic exposure: example of lung cancer and cigarette smoking. J Chronic Dis 40 (Suppl 2): 171S–179S.
Rockhill B, Colditz GA (2000) Smoking. In: Colditz GA, ed. Cancer Prevention: The Causes and Prevention of Cancer. The Netherlands: Kluwer Academy Publishers, pp. 3–13.
Stratton K, Shetty P, Wallace R, Bondurant S, eds. (2001) Clearing the Smoke. Washington, D.C.: National Academy Press.
Lee JS, Lippman SM, Benner SE, et al. (1994) Randomized placebo-controlled trial of isotretinoin in chemoprevention of bronchial squamous metaplasia. J Clin Oncol 12(5): 937–945.
Lee JJ, Liu D, Lee JS, et al. (2001) Long-term impact of smoking on lung epithelial proliferation in current and former smokers. JNCI Cancer Spectrum 93(14): 1081–1088.
California Department of Health Services. (2002) Fact sheet on adult Smoking prevalence in California. California Department of Health Services. Access Date: March 8, 2003. URL: http:// www.dhs.ca.gov/tobacco/documents/AdultSmoking.pdf.
Rothman KJ, Greenland S. (1998) Modern Epidemiology, 2nd edn. Philadelphia: Lippincott Williams & Wilkins.
Campaign for Tobacco Free Kids, American Lung Association, American Cancer Society, American Heart Association. (2002) Show us the money: A Mid-year update on the states' allocation of the tobacco settlement dollars. National Center for Tobacco Free Kids. July 22, 2002. Access Date: August 4. URL: http:// www.tobaccofreekids.org/reports/settlements/2002mid/2002midreport.pdf.
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Barnoya, J., Glantz, S. Association of the California Tobacco Control Program with Declines in Lung Cancer Incidence. Cancer Causes Control 15, 689–695 (2004). https://doi.org/10.1023/B:CACO.0000036187.13805.30
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DOI: https://doi.org/10.1023/B:CACO.0000036187.13805.30