Advertisement

Cancer Causes & Control

, Volume 14, Issue 6, pp 579–585 | Cite as

Lung cancer trends in young adults: an early indicator of progress in tobacco control (United States)

  • Ahmedin JemalEmail author
  • Vilma E. Cokkinides
  • Omar Shafey
  • Michael J. Thun
Article

Abstract

Objective: Tobacco smoking is known to increase lung cancer occurrence beginning in young adulthood, although age-specific rates have not been used to monitor the early consequences of tobacco control efforts in the United States. We evaluated state trends in lung cancer death rates among young adults in relation to an index of state tobacco control activities and conventional indices of current smoking and cessation. Methods: We calculated lung cancer death rates in young adults (age 30–39 years) over two time intervals from 1990–1994 through 1995–1999 in states with at least 25 deaths per interval. We measured the correlation of an index of state tobacco control in 1992–1993 with absolute rates and with total percent change during the two time intervals. Results: Both lung cancer death rates during the recent time interval (1995–1999) and the change in these rates from 1990–1994 correlated strongly and inversely with the index of state tobacco control efforts measured in 1992–1993. Lung cancer death rates decreased in states with high tobacco control efforts, but increased in states with low tobacco control efforts. Tobacco control indices were strongly and positively correlated with cessation of smoking by age 30–39 years. Conclusions: Lung cancer death rates among young adults are strongly and inversely correlated with recent indices of tobacco control. Future monitoring of the effectiveness of statewide comprehensive tobacco control programs should assess trends in lung cancer rates in young adults as well as youth and adult smoking prevalence.

epidemiology lung cancer tobacco control United States young adults 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jemal A, Thomas A, Murray T, Thun M (2002) Cancer Statistics 2002. CA Cancer J Clin 52: 23-47.Google Scholar
  2. 2.
    CDC (2002) Annual smoking-attributable mortality, years of potential life lost, and economic costs-United States, 1995-1999. MMWR 51(14): 300-303.Google Scholar
  3. 3.
    McCginnis J, Foege M (1993) Actual causes of death in the United States. JAMA 270: 2207-2212.Google Scholar
  4. 4.
    US Department of Health and Human Services (2000) Reducing Tobacco Use: a Report of the Surgeon General. Atlanta, Georgia: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health.Google Scholar
  5. 5.
    Bal D, Kizer K, Felton P, Mozar H, Niemeyer D (1990) Reducing tobacco consumption in California: development of a statewide anti-tobacco use campaign. JAMA 264: 1570-1574.Google Scholar
  6. 6.
    CDC (1996) Cigarette smoking before and after an excise tax increase and an antismoking campaign-Massachusetts, 1990-1996. MMWR 45: 966-970.Google Scholar
  7. 7.
    CDC (1998) Decline in Cigarette Consumption Following Implementation of a Comprehensive Tobacco Prevention and Education Program-Oregon, 1996-1998. MMWR 48: 140-143.Google Scholar
  8. 8.
    CDC (2001) Tobacco use among adults-Arizona, 1996 and 1999. MMWR 50: 402-406.Google Scholar
  9. 9.
    Bauer U, Johnson T, Hopkins R, Brooks R (2000) Changes in youth cigarette use and intentions following implementation of a tobacco control program: findings from the Florida Youth Tobacco Survey, 1998-2000. JAMA 284: 723-728.Google Scholar
  10. 10.
    Hu T, Bai J, Keeler T, Barnett P, Sung H (1994) The impact of California Proposition 99, a major anti-smoking law, on cigarette consumption. J Public Health Policy 15: 26-36.Google Scholar
  11. 11.
    Hu T, Ren Q, Keeler T, Bartlett J (1995) The demand for cigarettes in California and behavioural risk factors. Health Econ 4(1): 7-14.Google Scholar
  12. 12.
    Meier K, Licari M (1997) The effect of cigarette taxes on cigarette consumption, 1955 through 1994. AmJ Public Health 87: 1126-1130.Google Scholar
  13. 13.
    Peterson D, Zeger S, Remington P, Anderson H (1992) The effect of state cigarette tax increase on cigarette sales, 1955-1988. Am J Public Health 82: 92-96.Google Scholar
  14. 14.
    Stillman F, Becker D, Swank R, et al. (1990) Ending smoking at the Johns Hopkins Medical Institutions. An evaluation of smoking prevalence and indoor air pollution. JAMA 264(12): 1565-1569.Google Scholar
  15. 15.
    Becker D, Conner H, Waranch H, et al. (1989) The impact of a total ban on smoking in the Johns Hopkins Children's Center. JAMA 11(262): 799-802.Google Scholar
  16. 16.
    Borland R, Pierce J, Burns D, Gilpin E, Johnson M, Bal D (1992) Protection from environmental tobacco smoke in California. The case for a smoke-free workplace. JAMA 268(6): 749-752.Google Scholar
  17. 17.
    Farkas A, Gilpin E, Distefan J, Pierce J (1999) The effects of household and workplace smoking restrictions on quitting behaviours. Tob Control 8: 261-265.Google Scholar
  18. 18.
    Wakefield M, Chaloupka F (2000) Effectiveness of comprehensive tobacco control programmes in reducing teenage smoking in the USA. Tob Control 9: 177-186.Google Scholar
  19. 19.
    Gilpin E, Stillman F, Hartman A, Gibson J, Pierce J (2000) Index for US state tobacco control initial outcomes. Am J Epidemiol 152: 727-738.Google Scholar
  20. 20.
    Farrelly M, Pechacek T, Chaloupka F (2001) The Impact of Tobacco Control Program Expenditures on Aggregate Cigarette Sales: 1981-1998. Cambridge, MA: National Bureau of Economic Research.Google Scholar
  21. 21.
    Manley M, Pierce J, Gilpin E, Rosbrook B, Berry C, Wun L (1997) Impact of the American Stop Smoking Intervention Study on cigarette consumption. Tob Control 6(Suppl. 2): S12-S16.Google Scholar
  22. 22.
    Fichtenberg C, Glantz S (2000) Association of the California Tobacco Control Program with declines in cigarette consumption and mortality from heart disease. N Engl J Med 343: 1772-1777.Google Scholar
  23. 23.
    CDC (2000) Declines in Lung Cancer Rates-California, 1988-1997. MMWR 49: 1066-1069.Google Scholar
  24. 24.
    Doll R (1991) Progress against cancer: an epidemiologic assessment. The 1991 John C. Cassel memorial Lecture. Am J Epidemiol 134: 675-688.Google Scholar
  25. 25.
    Devesa S, Blot W, FraumeniJr JF (1989) Declining lung cancer rates among young men and women in the United States: a cohort analysis. J Natl Cancer Inst 81(20): 1568-1571.Google Scholar
  26. 26.
    Cummings K (1984) Changes in the smoking habits of adults in the United States and recent trends in lung cancer mortality. Cancer Detect Prev 7(3): 125-134.Google Scholar
  27. 27.
    Jemal A, Chu K, Tarone R (2001) Recent trends in lung cancer mortality in the United States. J Natl Cancer Inst 93: 277-283.Google Scholar
  28. 28.
    Thun M, Lally C, Flannery J, Calle E, Flanders W, Heath CJ (1997) Cigarette smoking and changes in the histopathology of lung cancer. J Natl Cancer Inst 89(21): 1580-1586.Google Scholar
  29. 29.
    Burns D, Jacqueline M, Shanks T, Thun M, Samet J (2001) Smoking lower yield cigarettes and disease risks. In: Risks Associated with Smoking Cigarettes with Low Machine-Measured Yields of Tar and Nicotine. Smoking and Tobacco Control, Monograph no. 13. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute, pp. 65-158.Google Scholar
  30. 30.
    World Health Organization (1977) Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Vol. 1, 9th revision. Geneva: WHO.Google Scholar
  31. 31.
    World Health Organization (1994) International statistical classi-fication of diseases and related health problems. Vol. 3, 10th revision. Geneva: WHO.Google Scholar
  32. 32.
    SAS Institute Inc (1989) SAS/STAT User's Guide, Version 6, 4th edn, Vol. 2. Cary, NC: SAS Institute Inc.Google Scholar
  33. 33.
    Biener L, Harris J, Hamilton W (2000) Impact of the Massachusetts tobacco control programme: population based trend analysis. BMJ 321: 351-254.Google Scholar
  34. 34.
    Blizzard L, Dwyer T (2001) Declining lung cancer mortality of young Australian women despite increased smoking is linked to reduced cigarette ‘tar’ yields. Br J Cancer 28(4): 392-396.Google Scholar
  35. 35.
    National Cancer Institute (2001) Changing Adolescent Smoking Prevalence. In: Smoking and Tobacco Control, Monograph no. 14. Bethesda, MD: US Department of Health and Human Services, National Institutes of Health, National Cancer Institute, November, Report no.: NIH pub. no. 02-5086.Google Scholar
  36. 36.
    Brown C, Chu K (1987) Use of multistage models to infer stage affected by carcinogenic exposure: example of lung cancer and cigarette smoking. J Chron Dis 40: 171S-179S.Google Scholar
  37. 37.
    Doll R, Peto R (1978) Cigarette smoking and bronchial carcinoma: dose and time relationships among regular smokers and life long non-smokers. J Epidemiol Commun Health 32: 303-313.Google Scholar
  38. 38.
    Peto R, Doll R (1984) The control of lung cancer. In: Mizell M, Correa P, eds. Lung Cancer: Causes and Prevention. Deerfield Beach (FL): Verlag Chemie International, pp. 1-19.Google Scholar

Copyright information

© Kluwer Academic Publishers 2003

Authors and Affiliations

  • Ahmedin Jemal
    • 1
    Email author
  • Vilma E. Cokkinides
    • 2
  • Omar Shafey
    • 2
  • Michael J. Thun
    • 2
  1. 1.Epidemiology and Surveillance ResearchAmerican Cancer SocietyAtlantaUSA
  2. 2.Epidemiology and Surveillance ResearchAmerican Cancer SocietyAtlantaUSA

Personalised recommendations