Researchers estimate that 48.5 percent of the nearly 346,000 deaths from 12 cancers among adults 35 and older in 2011 were attributable to cigarette smoking, according to an article published online by JAMA Internal Medicine.
Researcher Rebecca L. Siegel, M.P.H., of the American Cancer Society, Atlanta, and coauthors provide an updated estimate because they note smoking patterns and the magnitude of the association between smoking and cancer death have changed in the past decade. While smoking prevalence decreased from 23.2 percent in 2000 to 18.1 percent in 2012, some data suggest the risk of cancer death among smokers can increase over time, according to background in the study.
The authors used data from the 2011 National Health Interview Survey, the Cancer Prevention Study III and the pooled contemporary cohort. The National Health Interview Survey provides smoking prevalence estimates based on in-person interviews of a representative sample of U.S. adults and the other data sources ascertained smoking from self-administered questionnaires. The authors mention study limitations including that study populations were less racially diverse and more educated than the U.S. population and that tobacco exposures other than cigarettes were not included in the analysis.
The study estimates that of 345,962 deaths there were 167,805 attributable to smoking cigarettes. The largest proportions of smoking-attributable deaths were for cancers of the lung, bronchus and trachea (125,799, 80.2 percent) and larynx (2,856, 76.6 percent). About half of the deaths from cancers of the oral cavity, esophagus and urinary bladder were attributable to smoking, according to the results, which were reported in a research letter.
"Cigarette smoking continues to cause numerous deaths from multiple cancers despite half a century of decreasing prevalence. ... Continued progress in reducing cancer mortality, as well as deaths from many other serious diseases, will require more comprehensive tobacco control, including targeted cessation support," the study concludes.
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