The 13th World Conference on Tobacco OR Health

Objective: Tobacco is the number one cancer killer in the United States (US) with approximately 30 percent of all cancer deaths attributed to tobacco. With smoking prevalence among California adults declining in the past two decades, we analyzed the trends of smoking-attributable cancer mortality rate (SACMR), including cancers of lip/oral cavity/pharynx, esophagus, stomach, pancreas, larynx, trachea/lung/bronchus, cervix uteri, kidney/renal pelvis, urinary bladder, and acute myeloid leukemia.

Methods: The methods are similar to those described in the adult Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) software. Data were from the National Health Interview Study, the Surveillance, Epidemiology, and End Results program, and the American Cancer Society's Cancer Prevention Study II.

Results: The SACMR dropped 18.8% in California from 126.1 per 100,000 in 1979 to 102.4 in 2002, while the SACMR in the rest of the US dropped 2.4% from 125.7 per 100,000 to 122.7 during the same period. The Joinpoint regression model indicates an accelerated decrease of the SACMR in California since 1984 but a slower decrease in the rest of US since 1991. California men had a lower SACMR than the rest of the US with the difference growing from 4.0% in 1979 to 19.2% in 2002. The difference in the SACMR for women between California and the rest of the US went from 17.7 higher in 1979 to 10.4% lower in 2002. Our analyses indicate that smoking-related health outcomes happened earlier and accelerated in California in comparison to the rest of the US.