title: What proportion of cancer deaths in the contemporary United States is attributable to cigarette smoking?
abstract: OBJECTIVE
  The proportion of cancer deaths in the contemporary United States caused by cigarette smoking (the population attributable fraction [PAF]) is not well documented.
  
  
  METHODS
  The PAF of all cancer deaths due to active cigarette smoking among adults 35 years and older in the United States in 2010 was calculated using age- and sex-specific smoking prevalence from the National Health Interview Survey (NHIS) and age- and sex-specific relative risks from the Cancer Prevention Study-II (for ages 35-54 years) and from the Pooled Contemporary Cohort data set (for ages 55 years and older).
  
  
  RESULTS
  The PAF for active cigarette smoking was 28.7% when estimated conservatively, including only deaths from the 12 cancers currently formally established as caused by smoking by the US Surgeon General. The PAF was 31.7% when estimated more comprehensively, including excess deaths from all cancers. These estimates do not include additional potential cancer deaths from environmental tobacco smoke or other type of tobacco use such as cigars, pipes, or smokeless tobacco.
  
  
  CONCLUSIONS
  Cigarette smoking causes a large proportion of cancer deaths in the contemporary United States. Reducing smoking prevalence as rapidly as possible should be a top priority for the US public health efforts to prevent cancer deaths.
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA. Electronic address: Eric.Jacobs@cancer.org.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Jacobs
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA.
authors.forename: Christina C
authors.initials: CC
authors.lastname: Newton
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA.
authors.forename: Brian D
authors.initials: BD
authors.lastname: Carter
authors.affiliation: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Diane
authors.initials: D
authors.lastname: Feskanich
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.
authors.forename: Neal D
authors.initials: ND
authors.lastname: Freedman
authors.affiliation: Division of Public Health Sciences, Fred Hutchison Cancer Research Center, Seattle, WA.
authors.forename: Ross L
authors.initials: RL
authors.lastname: Prentice
authors.affiliation: Epidemiology Research Program, American Cancer Society, Atlanta, GA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA.
authors.forename: W Dana
authors.initials: WD
authors.lastname: Flanders
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000209:etiology / Q000401:mortality*; D011159:Population Surveillance / Q000379:methods*; D015995:Prevalence; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Cancer; Cigarettes; Mortality; Population attributable fraction; Smoking; Tobacco