Cigarette Smoking and Lung Cancer Trends: A Light at the End of the Tunnel?

doi:10.1378/chest.111.5.1414

Chest

Volume 111, Issue 5, May 1997, Pages 1414-1416

https://doi.org/10.1378/chest.111.5.1414 Get rights and content

Objective

To update the epidemic curves for lung cancer in the United States by gender in relation to the temporal trends in adult current cigarette smoking prevalence.

Methods

The design of the study was ecologic, based on population figures. Available data on the prevalence of current cigarette smoking from 1920 to 1990 were plotted in conjunction with age-adjusted lung cancer mortality rates from 1930 to 1992 for each sex.

Results

There was a strong temporal relationship between the curves for cigarette smoking prevalence and lung cancer mortality rate with approximately a 30-year population latency period in both men and women. The curves occurred later in women than in men. The lung cancer rate in men peaked in 1990 and then began to decline while the rate in women continued to rise.

Conclusion

The temporal association between cigarette smoking prevalence and lung cancer mortality provides additional support for the causal relationship between smoking and lung cancer.

Section snippets

MATERIALS AND METHODS

Cigarette smoking prevalence for US men and women aged 18 years and older in percent were obtained from two survey sources: (1) data published by Burbank³ for 1920 to 1960, and (2) data published by Giovino et al⁴ for 1965 to 1990. The percentages were plotted at 5-year intervals up to 1990.

Curves for annual lung cancer age-adjusted mortality rates (per 100,000) by sex from 1930 to 1992 were recently published by Parker et al.⁵ The exact rates were obtained (S. Parker, personal communication,

RESULTS

The curves for men are shown in Figure 1. The prevalence of current cigarette smokers was estimated to be 46% in 1920 and rose steadily to 65% in 1940, plateaued until 1955, and then began to decline progressively, reaching 28% in 1990.

The male lung cancer mortality rate was only 4.9/100,000/yr in 1930, rose slowly at first, and then more rapidly until 1980. Thereafter it slowed and peaked at 75.6 in 1990. The rate then fell to 74.6 in 1991 (not shown) and 73.1 in 1992. The population latency

DISCUSSION

Cigarette smoking prevalence estimates from 1955 on were based on national probability samples. The data prior to 1955 may not be as reliable. Estimates for men were based on annual marketing surveys by the Milwaukee Journal in its metropolitan area. Therefore the sample may not be representative of all US men. However, Burbank³ found that there was good agreement with national surveys beginning in 1955 and therefore used a straight line approximation for the early data. Milwaukee estimates for

ACKNOWLEDGMENT

The author is grateful to Sheryl L. Parker, MSPH, Surveillance Research Group, American Cancer Society, for providing the age-adjusted lung cancer mortality rates in the United States, 1930 to 1992.

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HillA.B.
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GiovinoG.A. et al.
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ParkerS.L. et al.
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GiovinoG.A. et al.
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(1995)

There are more references available in the full text version of this article.

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Chest

Special ReportCigarette Smoking and Lung Cancer Trends: A Light at the End of the Tunnel?

Objective

Methods

Results

Conclusion

Section snippets

MATERIALS AND METHODS

RESULTS

DISCUSSION

ACKNOWLEDGMENT

J Chron Dis

Report of the Advisory Committee to the Surgeon General of the Public Health Service. US Department of Health, Education, and Welfare

Public Health Service publication

The environment and disease: association or causation

Proc R Soc Med

Surveillance for selected tobacco-use behaviors—United States, 1900-1994

MMWR

Cancer statistics, 1996

CA Cancer J Clin

Epidemiology of tobacco use and dependence

Epidemiol Rev

Special Report
Cigarette Smoking and Lung Cancer Trends: A Light at the End of the Tunnel?