Respiratory Disease, Heart Disease Also Killing Thousands Annually

Cigarette smoking causes thousands of cancer deaths each year just in the U.S., but it’s taking a savage toll in several Southern states. A new report calls for increased tobacco control to stop the deception and carnage.

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The proportion of cancer deaths attributable to cigarette smoking varies substantially across states and is highest in the South, where up to 40 percent of cancer deaths in men are caused by smoking. Increasing tobacco control funding, implementing innovative new strategies, and strengthening tobacco control policies and programs, federally and in all states and localities, might further increase smoking cessation, decrease initiation, and reduce the future burden of morbidity and mortality associated with smoking-related cancers.

Smoking prevalence in the United States has been more than halved since the release of the first Surgeon General’s Report on the health hazards of cigarette smoking in 1964, as a result of increased awareness and implementation of public health policies against smoking. Nevertheless, there are still 40 million current adult cigarette smokers, and smoking remains the largest preventable cause of death from cancer and other diseases.

In 2014, at least 167 ,133 cancer deaths in the United States were caused by smoking, with the highest prevalence in Kentucky, Arkansas, Tennessee, West Virginia, and Louisiana.

The American Cancer Society study found the highest rate among men in Arkansas, where 40 percent of cancer deaths were linked to cigarette smoking. Kentucky had the highest rate among women — 29 percent. The lowest rates were in Utah, where 22 percent of cancer deaths in men and 11 percent in women were linked with smoking.

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“The human costs of cigarette smoking are high in all states, regardless of ranking,” the authors said.

The study likely underestimated deaths caused by tobacco use for several reasons. First, only 12 cancers were included, for consistency with the Surgeon General’s report; however, cigarette smoking is associated with excess mortality for additional cancers. Second, self-reported data are known to underestimate smoking prevalence. Third, deaths caused by tobacco exposures other than active cigarette smoking, including second-hand smoke, pipes, hookahs, cigars, smokeless tobacco, and electronic nicotine delivery systems, were not included in our analysis. Due to changing patterns of tobacco use, products other than cigarettes may account for a greater proportion of all tobacco-related cancer deaths in the future.

As of 2016, two-thirds of states still lack 100 percent smoke-free laws in public places to protect the general public from second-hand smoke; no state has taxes on cigarettes that account for at least 75 percent of the retail price, as recommended by the World Health Organization; and only 1 state (North Dakota) funds its tobacco control programs at the level recommended by the CDC. The study results were published Monday in JAMA Internal Medicine.

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