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Cited by 19Smoking Behavior and CessationGlobal Cancer Incidence and ScreeningInsurance, Mortality, Demography, Risk Management

Estimating Benefits of Past, Current, and Future Reductions in Smoking Rates Using a Comprehensive Model With Competing Causes of Death

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van Meijgaard, J, Fielding, JE·2012·Preventing Chronic Disease
DOI 10.5888/pcd9.110295PMC PMC3468309
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Abstract

INTRODUCTION: Despite years of declining smoking prevalence, tobacco use is still the leading preventable contributor to illness and death in the United States, and the effect of past tobacco-use control efforts has not fully translated into improvements in health outcomes. The objective of this study was to use a life course model with multiple competing causes of death to elucidate the ongoing benefits of tobacco-use control efforts on US death rates. METHODS: We used a continuous-time life course simulation model for the US population. We modeled smoking initiation and cessation and 20 leading causes of death as competing risks over the life span, with the risk of death for each cause dependent on past and current smoking status. Risk parameters were estimated using data from the National Health Interview Survey that were linked to follow-up mortality data. RESULTS: Up to 14% (9% for men, 14% for women) of the total gain in life expectancy since 1960 was due to tobacco-use control efforts. Past efforts are expected to further increase life expectancy by 0.9 years for women and 1.3 years for men. Additional reduction in smoking prevalence may eventually yield an average 3.4-year increase in life expectancy in the United States. Coronary heart disease is expected to increase as a share of total deaths. CONCLUSION: A dynamic individual-level model with multiple causes of death supports assessment of the delayed benefits of improved tobacco-use control efforts. We show that past smoking reduction efforts will translate into further increases in life expectancy in the coming years. Smoking will remain a major contributor to preventable illness and death, worthy of continued interventions.

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Cited by

Sorted by citations

Authors
van Meijgaard, J., & Fielding, J.
Affiliations
Los Angeles County Department of Public Health (US)
Venue
Preventing Chronic Disease
Publisher
Centers for Disease Control and Prevention - Preventing Chronic Disease
Published
2012-07
Volume
9
Pages
E122-E122
ISSN
1545-1151 (ISSN-L)
DOI
10.5888/pcd9.110295
PMC
PMC3468309
OpenAlex
W2102088339
Cited by
19
References
1
Citations by year
2025: 1 · 2021: 4 · 2020: 1 · 2019: 1 · 2017: 1 · 2016: 3 · 2015: 2 · 2014: 1 · 2013: 4 · 2012: 1
FWCI
1.93
Type
journal article
Language
en
Open access
Licence
public-domain
Locations
  • Preventing Chronic Disease (publishedVersion, public-domain)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
  • Social Sciences › Demography › Insurance, Mortality, Demography, Risk Management
Keywords
smoking prevalence reduction, tobacco control, life expectancy, competing risk of death, coronary heart disease mortality, preventable deaths
MeSH terms
Smoking Prevention, Adolescent, Adult, Alcohol Drinking, Cause of Death, Chronic Disease, Cost-Benefit Analysis, Cross-Sectional Studies, Female, Health Surveys, Humans, Life Expectancy, Male, Middle Aged, Mortality, National Center for Health Statistics, U.S., Occupations, Smoking, Social Class, United States, Exercise, Body Mass Index, Prevalence, Occupational Health, Smoking Cessation, Age of Onset, Sex Distribution, Capacity Building

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