Usefulness of tobacco check boxes on death certificates: Texas, 1987-1998.
OBJECTIVE
We compared reports of deaths in which tobacco use was a contributing factor ("tobacco-associated deaths") before and after the addition to death certificates in Texas of a check-box question asking whether tobacco use contributed to an individual's death.


METHODS
We examined Texas vital statistics files from 1987 to 1998. We calculated differences in percentages of reported tobacco-associated deaths (and 95% confidence intervals [CIs]) for the periods 1987 to 1992, before the addition of the check-box question, and 1993 to 1998, after the addition of the check-box.


RESULTS
Reports of tobacco-associated deaths were significantly less frequent before addition of the check-box question (0.7%; 95% CI = 0.4%, 1.0%) than after addition of the question (13.9%; 95% CI = 13.0%, 14.7%). From 1993 to 1998, percentages of tobacco-associated deaths reported on the check-box question increased steadily.


CONCLUSIONS
The addition of a tobacco-associated-death check box on Texas death certificates significantly increased reporting of tobacco use contributions to mortality.
Zevallos
Juan Carlos
JC
Texas Tech University Health Sciences Center at El Paso, 79902, USA. zevallos@elp.rr.com
Huang
Philip
P
Smoot
Monica
M
Condon
Kenneth
K
Alo
Celan
C
D002423:Cause of Death; D016001:Confidence Intervals; D003644:Death Certificates; D005568:Forms and Records Control / Q000379:methods / Q000592:standards*; D006801:Humans; D008499:Medical Records / Q000592:standards* / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D011785:Quality Assurance, Health Care; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality*; D013781:Texas / Q000453:epidemiology; D014029:Tobacco Use Disorder / Q000401:mortality*