Tobacco Documents Online

Draft MORTALITY TRENDS AMONG SMOKERS AND NONSMOKERS IN THE UNITED STATES: 1966-86 James E. Enstrom, Ph.D., M.P.H. School of Public Health University of California Los Angeles, CA 90024 December 1, 1995 ABSTRACT Mortality trends among smokers and nonsmokers in the United States have been analyzed using representative samples from the 1966-68 National Mortality Survey and the 1986 National Mortality Followback Survey. There have been declines of over 30% in total death rates for nonsmokers, smokers, and the total population from 1966 to 1986 with the declines somewhat greater for the nonsmokers than for smokers and somewhat greater for all cardiovascular diseases than for other causes. The declines are so large that the 1986 total death rates for U. S. white cigarette smokers who are married with 12+ years of education are about the same as the 1966-68 total death rates for U. S. whites who never smoked cigarettes. In spite of a substantial degree of smoking cessation and a large reduction in tar and nicotine levels in cigarettes during the past 30 years, there has been no decline in overall lung cancer death rate among males and there has been a large increase in the rate among women. Also, death rates for smoking-related diseases in the population as a whole are not converging toward the corresponding death rates those who have never smoked over the 1966-86 period. Indeed, the cardiovascular disease and total death rates have declined faster for never smokers than they have for current smokers, even controlling for amount smoked. The number of deaths that are 'due to' smoking and that can currently be prevented by smoking cessation may be smaller than the widely accepted estimates that rely on extrapolations from non-representative data and do not account for the large secular declines in death rates during the past 40 years.