Tobacco Documents Online

#582 - Enstrom, J.E. , Los Angeles, CA., "Cancer Mortality and Smoking Cessation Among California Physicians." Enstrom has been following a cohort of California physicians since 1950 studyin g their rortality trends and how these trends have been affected by smoking cessation by this cohort. (16,000). The data in the study is at present 98% complete. Several on-going studies were combined to m ake the count larger. The two major studies are the California Medical Association Survey (since 1966) and the Alameda County Medical Society survey (1950). In the period 1950-1980, the sample surveys indicate that while all U.S. males who smoke (as a percent of the population of U.S. males) declined f rom 55% to 38%, the California male M.D. cohort showed a decline from 50% to 10%. Concerning mortality, the physicians showed 9,500 deaths, com- pared with an expected mortality (all causes) of 11,000. Preliminary results indicate that Standard Mortality Ratio (SMR) for California M.D.s compared with U.S. white males appears to have remained relatively constant at about 850(1950-1979). However the SMR for lung cancer appea rs to be declining from about 550(1950-9) to about 40%(1970-79). When this is "age adjusted" the lung cancer death rate for California M.D.s appears to have remained relatively constant, while apparently rising in all U.S. males. CONFIDENTIAL: MINNESOTA TOBACCO LITIGATION TIMN 0251347

#582 continued Note: Enstrom commented that sub-group of Lonia Luida, Seventh Day Adventist M.D.s all never smokers is included in this cohort and showed an overall decline in mortality from all cancers (1950-79) from 62% to 56%. (a 6% drop) CONFIDENTIAL: r'IN~.N 0251348 MINNESOTA TOBACCO LITIGATION