August 29, 2022 — Nearly 123,000 cancer deaths — or nearly 30% of all cancer deaths — in the United States in 2019 were linked to cigarette smoking, according to a new analysis.
That’s the equivalent of more than 2 million person-years of lost life and nearly $21 billion in lost revenue annually.
“Over the past several decades, smoking in the United States has declined significantly, followed by a sharp decline in mortality from lung cancer and some other smoking-related cancers,” says lead author Farhad Islami, MD, senior scientific director of Cancer Disparity Research at the American cancer society.
Despite this “remarkable progress, our results show that smoking is still associated with about 30% of all cancer deaths and significant loss of income in the US, and that more work should be done to further reduce smoking in the country,” he says.
The study was published online on August 10 in International Journal of Cancer.
Islami and colleagues found that lost revenue from cancer deaths was nearly $95 billion in 2015. Other research showed that a significant portion of the loss of income from cancer was due to cigarette smoking, but the estimates were more than a decade old.
To provide more recent estimates and to serve as a guide for tobacco control policy, Islami and colleagues estimated years of life lost (PYLL)and lost revenue from cigarette smoking-related cancer deaths in 2019.
Of the 418,563 cancer deaths in adults aged 25 to 79, an estimated 122,951 could be related to cigarette smoking. This corresponds to 29.4% of all cancer deaths and around 2.2 million PYLL. Converted to income losses, the authors estimated a total of US$20.9 billion, with an average income loss of US$170,000 per smoking-related cancer death.
By cancer type, lung cancer accounted for about 62%, or $12.9 billion, of the total loss of income related to smoking, followed by esophageal cancer (7%, or $1.5 billion), colorectal cancer (6%, or $1.2 billion). US$) and liver cancer (5% or US$1.1 billion).
Smoking-related death rates were highest in the 13 “Tobacco Nations” states with weaker tobacco control policies and higher rates of cigarette smoking. These states are Alabama, Arkansas, Indiana, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Ohio, Oklahoma, South Carolina, Tennessee and West Virginia.
The income loss rate in all 13 tobacco nation-states combined was about 44% higher than other states and the District of Columbia combined, and the annual PYLL rate was 47% higher in tobacco nation-states.
The researchers estimated that more than half of all statewide PYLL and lost income would have been avoided if all states’ rates of PYLL and lost income were the same as those in Utah, which has the lowest rates. In other words, that would mean 1.27 million PYLL and $10.5 billion in savings in 2019.
No more “scourge of tobacco”
To quit smoking, health care providers should “screen patients for tobacco use, document tobacco use status, advise smokers to quit, and assist in attempts to quit,” Islami says.
It’s also important that more people in the US are screened for lung cancer, as only 6.6% of eligible people were screened in 2019.
In a statement, Lisa Lacasse, president of the American Cancer Society’s Cancer Action Network, said this report “continues to show how crucial reducing tobacco use is to ending suffering and death from cancer.”
To end the “scourge of tobacco,” local, state, and federal legislatures must adopt best-practice tobacco control policies, she said.
These include regular and significant tobacco tax increases, thorough statewide anti-smoking laws, and adequate funding for government programs to prevent and quit smoking. It also means ensuring that all Medicaid registrants have access to all services that can help smokers quit, as well as access to all FDA-approved medications to help users quit.
“We have the tools to make this happen, we just need the legislature to act,” Lacasse said.