Rising lung cancer mortality in the United States, 1968-1988: the manifestation of altered disease competition.

Lung cancer mortality is increasing. The strong association between cigarette smoking and lung cancer is universally acknowledged. Consequently, rising lung cancer mortality is commonly attributed to cigarette smoking. This chain of logic has resulted in a remarkable evolution of public attitudes toward cigarette smoking and in increased regulation of smoking at work and in public places. However, longitudinal Gompertzian analysis indicates that the major force increasing lung cancer mortality in the United States is the declining competitiveness of other causes of death, particularly ischemic heart disease and stroke. Indeed, this analysis demonstrates that the "environmental" influence upon lung cancer mortality began to decline in the United States in the mid-1970s, supporting the effectiveness of programs aimed at decreasing tobacco use.