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CA: A Cancer Journal for Clinicians, Vol 38, 28-58, Copyright © 1988 by American Cancer Society

Smoking and Death Rates—Report on Forty-Four Months Of Follow-up of 187,783 Men

There is a high degree of association between total death rates and cigarette smoking, a far lower degree of association between total death rates and cigar smoking, and a small degree of association between total death rates and pipe smoking. The available source of information for this study, on diseases involved, was cause of death as recorded on death certificates, supplemented by more detailed medical information in cases in which cancer was mentioned.

The following relationships with cigarette smoking are evident:

1. An extremely high association for a few diseases, such as cancer of the lung, cancer of the larynx, cancer of the esophagus, and gastric ulcers.

2. A very high association for a few diseases, such as pneumonia and influenza, duodenal ulcer, aortic aneurysm, and cancer of the bladder.

3. A high association for a number of diseases, such as coronary artery disease, cirrhosis of the liver, and cancer of several sites.

4. A moderate association for cerebral vascular lesions.

5. Little or no association for a number of diseases, including chronic rheumatic fever, hypertensive heart disease, other hypertensive diseases, nephritis and nephrosis, diabetes, leukemia, cancer of the rectum, cancer of the colon, and cancer of the brain. The relative importance of the association listed above is dependent on the number of deaths attributed to each disease, as well as on their degrees of association with cigarette smoking.

It was found that the death rate of men with lung cancer who had given up cigarette smoking for a year or more before being enrolled in the study was lower than the death rate of men who were smoking cigarettes regularly at that time. An extremely high association between cigarette smoking and death rates for men with this disease was found in rural areas as well as in large cities. If smoking habits are taken into consideration, the lung cancer death rate was somewhat higher in cities than in rural areas.

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