Prevention Matters

Partnership for Prevention Interim President Corinne G. Husten, MD, MPH, co-authored a study released this week by the Centers for Disease Control and Prevention (CDC) that was the first 50-state analysis of patterns in smoking-related death rates.

“Overall, the report shows that we made progress in reducing smoking-related deaths during the period studied," says Husten, who served as director of the CDC’s Office on Smoking and Health at the time the study was conducted. “On a state-by-state level the results vary widely, but they show that tobacco continues to take its toll among adults in terms of death rates and years of life lost - particularly in states with higher smoking rates.”

According to the report, smoking rates in the U. S. took a downward plunge and the states with the highest smoking rates had the highest death rates from smoking. Kentucky, the leader, had a smoking death rate of 371 deaths out of every 100,000 adults age 35 and older, a rate that was almost one-and-a-half times higher than the national median of 263 per 100,000. Utah, the lowest state in the list had a death rate of 138 per 100,000.

The report highlighted that the smoking rates in fell in 49 of the 50 U. S. states with only Oklahoma showing an increase. In the four-year period ending in 1999 the annual rate of smoking related deaths fell from 288 per 100,000 people, to 263 per 100,000 in the five years ending in 2004.

"The patterns in this study to some degree predate our expanded efforts in tobacco prevention and control over the past decade," Husten said. "As we continue to monitor these data, they will take into account the programs that have been implemented since then, and we expect to see additional progress.

“Unfortunately, we’re still not providing the resources recommended by the CDC to combat the problem," she said. "If we were to do so, we would see even more progress. Every death from tobacco use is preventable, and any death from tobacco is one too many. It is unconscionable that we are allowing 1200 Americans to die each day because we are unwilling to implement the interventions that have been proven to work.

“This is the first time that we have analyzed patterns in attributable mortality rates," she said. "These data give us important information that is not available from just looking at the number of deaths, but this information is complicated and should not be viewed in isolation. First, we only have two data points, so we really can’t talk about 'trends' until we have more data. Second, smoking causes 19 diseases, including 10 types of cancer and chronic lung disease. So, while the impact on heart disease deaths is rapid, it takes longer to see the impact of our programs on these other diseases.”