Tobacco control–driven reductions in smoking prevalence may have helped avert over 3.8 million lung cancer–related deaths and gain just over 76 million years of life between 1970 and 2022 in the United States, according to a recent study published by Islami et al in CA: A Cancer Journal for Clinicians.
Background
“The substantial estimated numbers of averted lung cancer deaths and person-years of life gained highlight the remarkable effect of progress against smoking on reducing premature mortality from lung cancer,” emphasized lead study author Farhad Islami, MD, PhD, Senior Scientific Director of Cancer Disparity Research at the American Cancer Society (ACS). “However, despite these findings, lung cancer is still the leading cause of cancer death in the United States, and smoking-attributable morbidity and mortality from other cancers or diseases remain high,” he added.
Study Methods and Results
In the study, investigators used 1970 to 2022 National Center for Health Statistics mortality data with national coverage to analyze the rate of lung cancer–related mortality. The number of averted deaths was calculated by subtracting the observed number of deaths from the expected number in each year, age, sex, race, and age group. Person-years of life gained were estimated as a measure of avoided premature mortality based on the average additional years a patient would have lived if they hadn’t died from lung cancer. Because mortality rates for all cancers combined have declined in recent decades, the investigators also estimated the proportion of averted all cancer–related deaths from 1970 to 2022 that were attributable to the averted lung cancer burden.
The investigators found that nearly 3.9 million lung cancer–related deaths (n = 2.2 million in male patients and 1.6 million in female patients) were averted and nearly 76.3 million person-years of life (n = 40.3 million in male patients and 36 million in female patients) were gained during the 1970 to 2022 study period—with an average of 19.8 person-years of life gained (n = 17.9 in male patients and 22.4 in female patients) per averted death. The number of averted lung cancer–related deaths accounted for 51.4% of the estimated declines in overall cancer–related mortality and was substantially greater among male patients (60.1%) compared with female patients (42.7%). By race, this proportion was 53.6% among White patients (62.6% in male patients and 44.6% in female patients) and 40.0% among Black patients (44.4% in male patients and 34.7% in female patients).
Conclusions
“Reducing smoking through tobacco control has saved millions of lives and can save millions more in the future, [b]ut we need a stronger commitment at the local, state, and federal levels to help further reduce smoking and substantially augment the progress against smoking-related mortality,” indicated Dr. Islami. “It’s also important that these tobacco control programs be designed to reach groups at a higher risk of smoking, such as [individuals] of lower socioeconomic status, to help save even more lives. For example, smoking prevalence and lung cancer mortality rates in [patients] with a high school diploma or lower education levels are 5 times higher compared with individuals with a college degree,” he continued.
“Increased and sustained funding for evidence-based tobacco prevention and cessation programs is needed now more than ever as part of a comprehensive approach to reducing tobacco use and, ultimately, the cancer burden for everyone in the [United States],” underlined Lisa A. Lacasse, MBA, President of the ACS Cancer Action Network. “The study’s findings show the impact of past tobacco control measures but also underscore the preventable deaths that continue to persist. Access to barrier-free, culturally competent cessation services, substantially increasing tobacco taxes, and implementing comprehensive smoke-free policies are proven policies to help [individuals] quit and prevent [them], especially youth, from ever starting,” she concluded.
Disclosure: For full disclosures of the study authors, visit acsjournals.onlinelibrary.wiley.com.
