Jeez. Smoking is just terrible.

I’ve often marveled at how much things have changed with respect to smoking. When I was younger, it felt ubiquitous. I barely see it anymore. When I visited Amherst College (my alma mater) a couple years ago, I saw no one smoking at all. My kids feel free to make public displays of displeasure when they come across the rare person smoking in public anymore. It’s one of the great public health achievements of our time.

It’s still not enough. From JAMA Internal Medicine:

Importance: State-specific information about the health burden of smoking is valuable because state-level initiatives are at the forefront of tobacco control. Smoking-attributable cancer mortality estimates are currently available nationally and by cancer, but not by state.

Objective: To calculate the proportion of cancer deaths among adults 35 years and older that were attributable to cigarette smoking in 2014 in each state and the District of Columbia.

Design, Setting, and Participants: The population-attributable fraction (PAF) of cancer deaths due to cigarette smoking was computed using relative risks for 12 smoking-related cancers (acute myeloid leukemia and cancers of the oral cavity and pharynx; esophagus; stomach; colorectum; liver; pancreas; larynx; trachea, lung, and bronchus; cervix uteri; kidney and renal pelvis; and urinary bladder) from large US prospective studies and state-specific smoking prevalence data from the Behavioral Risk Factor Surveillance System.

Main Outcomes and Measures: The PAF of cancer deaths due to cigarette smoking in each US state and the District of Columbia.

Researchers wanted to determine the proportion of cancer deaths in adults age 35 years or older which were attributable to cigarette smoking in 2014. They did this by calculating the relative risks for twelve smoking-related cancers among states with different prevalences of smoking. Boom.

In 2014, there were more than 167,000 cancer deaths that were attributable to smoking. This accounted for almost 29% of all cancer deaths. Get that? Almost 30% of cancer deaths can be laid at the feet of smoking cigarettes. In 2014.

Utah had the lowest rates for both men and women. Nine of the top states for men and six of the top states for women were in the South.

In the worst states, smoking explained almost 40% of cancer deaths. In the worst states, it explained more than a quarter of cancer deaths for women.

Things are better than they used to be. But they’re still shockingly bad. Smoking cigarettes is just terrible for you.


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