Farhad Islami1, Priti Bandi2, Liora Sahar2, Jiemin Ma2, Jeffrey Drope2,3, Ahmedin Jemal2. 1. Data Science Research Program, American Cancer Society, Atlanta, GA, USA. farhad.islami@cancer.org. 2. Data Science Research Program, American Cancer Society, Atlanta, GA, USA. 3. School of Public Health, University of Illinois at Chicago, Chicago, IL, USA.
Abstract
PURPOSE: There are limited data on the burden of cancer attributable to cigarette smoking by metropolitan areas to inform local tobacco control policies in the USA. We estimated the proportion of cancer deaths attributable to cigarette smoking (or population attributable fraction [PAF]) in 152 U.S. metropolitan or micropolitan statistical areas (MMSAs). METHODS: Smoking-related PAFs for cancer mortality in ages ≥ 30 years in 2013-2017 were estimated using cross-sectional age-, sex-, and MMSA-specific cigarette smoking prevalence and cancer mortality data obtained from the Behavioral Risk Factor Surveillance System and the U.S. Cancer Statistics Database, respectively. RESULTS: Overall smoking-related PAFs of cancer ranged from 8.8% (95% CI, 6.3-11.9%) to 35.7% (33.3-37.9%); MMSAs with the highest PAFs were in the South region and Appalachia. PAFs also substantially varied across MMSAs within regions or states. In the Northeast, for example, the PAF ranged from 24.2% (23.7-24.7%) to 33.7% (31.3-36.2%). CONCLUSION: The proportion of cancer deaths attributable to cigarette smoking is considerable in each MMSA, with as many as 4 in 10 cancer deaths attributable to smoking in the South region and Appalachia. Broad and equitable implementation and enforcement of proven tobacco control interventions at all government levels could avert many cancer deaths across the USA.
PURPOSE: There are limited data on the burden of cancer attributable to cigarette smoking by metropolitan areas to inform local tobacco control policies in the USA. We estimated the proportion of cancer deaths attributable to cigarette smoking (or population attributable fraction [PAF]) in 152 U.S. metropolitan or micropolitan statistical areas (MMSAs). METHODS: Smoking-related PAFs for cancer mortality in ages ≥ 30 years in 2013-2017 were estimated using cross-sectional age-, sex-, and MMSA-specific cigarette smoking prevalence and cancer mortality data obtained from the Behavioral Risk Factor Surveillance System and the U.S. Cancer Statistics Database, respectively. RESULTS: Overall smoking-related PAFs of cancer ranged from 8.8% (95% CI, 6.3-11.9%) to 35.7% (33.3-37.9%); MMSAs with the highest PAFs were in the South region and Appalachia. PAFs also substantially varied across MMSAs within regions or states. In the Northeast, for example, the PAF ranged from 24.2% (23.7-24.7%) to 33.7% (31.3-36.2%). CONCLUSION: The proportion of cancer deaths attributable to cigarette smoking is considerable in each MMSA, with as many as 4 in 10 cancer deaths attributable to smoking in the South region and Appalachia. Broad and equitable implementation and enforcement of proven tobacco control interventions at all government levels could avert many cancer deaths across the USA.
Entities:
Keywords:
Burden; Cancer; Epidemiology; Population attributable fraction; Smoking
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