Cancer deaths caused by smoking result in more than 2 million person-years of lost life (PYLL) and nearly $21 billion in annual lost earnings, according to research from the American Cancer Society (ACS) published August 10 in the International Journal of Cancer.
What's more, these losses were disproportionately felt in U.S. states with weaker tobacco control policies in the South and Midwest, according to the researchers led by Dr. Farhad Islami, senior scientific director for cancer disparity research at the ACS.
"Our study provides further evidence that smoking continues to be a leading cause of cancer-related death and to have a huge impact on the economy across the U.S.," Islami said in a statement from the ACS. "We must continue to help individuals to quit using tobacco, prevent anyone from starting, and work with elected officials at all levels of government for broad and equitable implementation of proven tobacco control interventions."
In their study, the researchers estimated the proportions and numbers of cancers attributable to cigarette smoking, as well as their associated PYLL and lost earnings, in individuals ages 25 to 79 in the U.S. in 2019. They also used education-specific data for each state to account for variations in employment status, wages, and smoking-attributable mortality by socioeconomic status.
The analysis encompassed a variety of smoking-related cancers: cancers of the oral cavity, pharynx, esophagus, stomach, colorectum, liver and intrahepatic bile duct, pancreas, larynx, lung and bronchus, cervix, kidney and renal pelvis, and urinary bladder, as well as acute myeloid leukemia.
The researchers found that death rates were highest in the 13 states with generally weaker tobacco control policies and higher cigarette smoking prevalence, including the following: Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, and West Virginia.
These 13 states had an annual PYLL of 1,431 per 100,000 population, 46.8% higher than the 975 per 100,000 population found in the other states and Washington, DC. In addition, the lost earnings rate for these 13 states was also 44.8% higher than in other states and Washington, DC, ($11.2 million per 100,000 population vs. $7.8 million per 100,000).
In other findings, the researchers concluded if the PYLL and lost earning rates in the state with the lowest PYLL rate -- Utah -- were achieved by all other states, more than half of the estimated total PYLL and lost earnings in 2019 nationwide would have been avoided. The proportion of avoidable PYLL was more than 50% in 39 states and Washington, DC, while the proportion of avoidable lost earnings was greater than 50% in 30 states.