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Demography

, Volume 55, Issue 5, pp 1855–1885 | Cite as

Cigarette Smoking and All-Cause and Cause-Specific Adult Mortality in the United States

  • Joseph T. Lariscy
  • Robert A. Hummer
  • Richard G. Rogers
Article

Abstract

This study illuminates the association between cigarette smoking and adult mortality in the contemporary United States. Recent studies have estimated smoking-attributable mortality using indirect approaches or with sample data that are not nationally representative and that lack key confounders. We use the 1990–2011 National Health Interview Survey Linked Mortality Files to estimate relative risks of all-cause and cause-specific mortality for current and former smokers compared with never smokers. We examine causes of death established as attributable to smoking as well as additional causes that appear to be linked to smoking but have not yet been declared by the U.S. Surgeon General to be caused by smoking. Mortality risk is substantially elevated among smokers for established causes and moderately elevated for additional causes. We also decompose the mortality disadvantage among smokers by cause of death and estimate the number of smoking-attributable deaths for the U.S. adult population ages 35+, net of sociodemographic and behavioral confounders. The elevated risks translate to 481,887 excess deaths per year among current and former smokers compared with never smokers, 14 % to 15 % of which are due to the additional causes. The additional causes of death contribute to the health burden of smoking and should be considered in future studies of smoking-attributable mortality. This study demonstrates that smoking-attributable mortality must remain a top population health priority in the United States and makes several contributions to further underscore the human costs of this tragedy that has ravaged American society for more than a century.

Keywords

Smoking Mortality Cause of death Smoking-attributable mortality National Health Interview Survey 

Notes

Acknowledgments

An earlier draft of this article was presented at the 2016 annual meeting of the Population Association of America, Washington, DC. We are grateful to the Carolina Population Center, University of North Carolina at Chapel Hill and its Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) center grant (P2C HD050924), University of Colorado Population Center, University of Colorado–Boulder and its NICHD center grant (P2C HD066613), and Duke Population Research Institute, Duke University and its National Institute on Aging (NIA) training grant (T32 AG000139) for general support. We thank Charles Nam, Arun Hendi, Negasi Beyene, three anonymous Demography reviewers, and seminar participants at Florida State University, Syracuse University, and the University of Missouri for helpful comments. We thank NCHS for providing a special-request version of the NHIS-LMF data. The research in this article was conducted in the Missouri Federal Statistical Research Data Center (RDC) in Columbia, Missouri, and Triangle RDC in Durham, North Carolina, while the first author was a Special Sworn Status researcher of the U.S. Census Bureau at the Center for Economic Studies. The content of this article is the sole responsibility of the authors and does not necessarily represent the official views of the U.S. Census Bureau, NCHS, NIA, NICHD, or the National Institutes of Health. This article was screened to ensure that no confidential data are revealed.

Supplementary material

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Copyright information

© Population Association of America 2018

Authors and Affiliations

  • Joseph T. Lariscy
    • 1
  • Robert A. Hummer
    • 2
  • Richard G. Rogers
    • 3
  1. 1.Department of SociologyUniversity of MemphisMemphisUSA
  2. 2.Carolina Population Center and Department of SociologyUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Population Program, IBS, and Department of SociologyUniversity of Colorado-BoulderBoulderUSA

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