Tobacco smoke overload and ethnic, state, gender, and temporal cancer mortality disparities in Asian-Americans and Pacific Islander-Americans.
BACKGROUND
Asians and Pacific Islanders (APIs) are important populations nationally and globally. So we assessed cumulative tobacco smoke overexposure (smoke overload)/cancer mortality associations across states, ethnicities, years, and genders among API-Americans.


METHODS
Death rates were adjusted to the 2000 United States age standard, lung cancer death rates used as a smoke overload bio-index, and lung/non-lung cancer death rate linear regressions run. Cancer death rate smoking-attributable fractions (SAFs) are equal to 1--estimated unexposed rate/observed rate.


RESULTS
The two lowest smoke overload and non-lung cancer death rates were in South Asian (Indo)-Californian females and males. The highest were in Korean-Californian males. Non-lung cancer death rates were tightly and steeply associated with smoke overload across ethnicity, state, year, or gender. Cancer death rate smoking-attributable fractions ranged from 0 in female and 6% in male Indo-Californians, to 39% in female and 57% in male API-Americans in 2002, to 71% in Korean-Californian and 69% in API Hawaiian males.


CONCLUSIONS
Many API American cancer death rate disparities across genders, ethnicities, states, or years can be explained by smoke overload disparities. Tobacco control may greatly reduce cancer death rates and disparities among API-Americans and, likely, others.
Department of Public Health Sciences, University of California, Davis, CA 95616-8638, USA. BNLeistikow@ucdavis.edu
Bruce N
BN
Leistikow
Moon
M
Chen
Alexander
A
Tsodikov
D001213:Asian; D005260:Female; D006801:Humans; D016014:Linear Models; D008175:Lung Neoplasms / Q000208:ethnology / Q000401:mortality; D008297:Male; D044468:Native Hawaiian or Pacific Islander; D009369:Neoplasms / Q000208:ethnology / Q000401:mortality*; D018426:SEER Program; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology; D013997:Time Factors; D014481:United States / Q000453:epidemiology