title: Impact of reduced tobacco smoking on lung cancer mortality in the United States during 1975-2000.
abstract: BACKGROUND
  Considerable effort has been expended on tobacco control strategies in the United States since the mid-1950s. However, we have little quantitative information on how changes in smoking behaviors have impacted lung cancer mortality. We quantified the cumulative impact of changes in smoking behaviors that started in the mid-1950s on lung cancer mortality in the United States over the period 1975-2000.
  
  
  METHODS
  A consortium of six groups of investigators used common inputs consisting of simulated cohort-wise smoking histories for the birth cohorts of 1890 through 1970 and independent models to estimate the number of US lung cancer deaths averted during 1975-2000 as a result of changes in smoking behavior that began in the mid-1950s. We also estimated the number of deaths that could have been averted had tobacco control been completely effective in eliminating smoking after the Surgeon General's first report on Smoking and Health in 1964.
  
  
  RESULTS
  Approximately 795,851 US lung cancer deaths were averted during the period 1975-2000: 552,574 among men and 243,277 among women. In the year 2000 alone, approximately 70,218 lung cancer deaths were averted: 44,135 among men and 26,083 among women. However, these numbers are estimated to represent approximately 32% of lung cancer deaths that could have potentially been averted during the period 1975-2000, 38% of the lung cancer deaths that could have been averted in 1991-2000, and 44% of lung cancer deaths that could have been averted in 2000.
  
  
  CONCLUSIONS
  Our results reflect the cumulative impact of changes in smoking behavior since the 1950s. Despite a large impact of changing smoking behaviors on lung cancer deaths, lung cancer remains a major public health problem. Continued efforts at tobacco control are critical to further reduce the burden of this disease.
authors.affiliation: Program in Biostatistics and Biomathematics, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave North, Seattle, WA 98109, USA. smoolgav@fhcrc.org
authors.forename: Suresh H
authors.initials: SH
authors.lastname: Moolgavkar
authors.forename: Theodore R
authors.initials: TR
authors.lastname: Holford
authors.forename: David T
authors.initials: DT
authors.lastname: Levy
authors.forename: Chung Yin
authors.initials: CY
authors.lastname: Kong
authors.forename: Millenia
authors.initials: M
authors.lastname: Foy
authors.forename: Lauren
authors.initials: L
authors.lastname: Clarke
authors.forename: Jihyoun
authors.initials: J
authors.lastname: Jeon
authors.forename: William D
authors.initials: WD
authors.lastname: Hazelton
authors.forename: Rafael
authors.initials: R
authors.lastname: Meza
authors.forename: Frank
authors.initials: F
authors.lastname: Schultz
authors.forename: William
authors.initials: W
authors.lastname: McCarthy
authors.forename: Robert
authors.initials: R
authors.lastname: Boer
authors.forename: Olga
authors.initials: O
authors.lastname: Gorlova
authors.forename: G Scott
authors.initials: GS
authors.lastname: Gazelle
authors.forename: Marek
authors.initials: M
authors.lastname: Kimmel
authors.forename: Pamela M
authors.initials: PM
authors.lastname: McMahon
authors.forename: Harry J
authors.initials: HJ
authors.lastname: de Koning
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Feuer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology* / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009026:Mortality / Q000639:trends; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D014481:United States / Q000453:epidemiology