Overall rates of smoking-attributable mortality declined in 49 states and the District of Columbia from 1996–1999 to 2000–2004, with the greatest drops occurring in Nevada, California, and Virginia.
New state-specific data on smoking-attributable mortality (SAM) and years of potential life lost (YPLL) from the Centers for Disease Control and Prevention show that average annual overall SAM rates decreased during the two time periods by 44.4/100,000 population older than 35 years of age in Nevada, by 37.8/100,000 in California, and by 33.4/100,000 in Virginia. Oklahoma was the only state that experienced an increase in SAM, by 26.9/100,000 (MMWR 2009;58:29–33).
Sex- and age-specific SAMs were calculated by multiplying the total number of deaths among adults older than 35 years from 19 diseases caused by cigarette smoking by estimates of the smoking-attributable fraction of preventable deaths for each disease.
Compared with 1996–1999, the average annual SAM rates declined in 2000–2004 among men in all states except Oklahoma, but increased among women in several states (Alabama, Arizona, Arkansas, Georgia, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Michigan, North Carolina, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas) and D.C. For every state, the annual number of smoking-related deaths was higher among males than among females, the CDC said.
The release of these state-specific data follow a 2008 report that cigarette smoking and exposure to secondhand smoke resulted in an estimated 443,000 deaths and 5.1 million YPLL annually in the United States during 2000–2004 (MMWR 2008;57:1226–8).
During 2000–2004, overall average annual SAM rates per 100,000 population were lowest in Utah (138.3), Hawaii (167.6), and Minnesota (215.1), and highest in Kentucky (370.6), West Virginia (344.3), and Nevada (343.7). Median SAM rates per 100,000 population overall were 288.1 for 1996–1999 and 263.3 for 2000–2004.
Smoking-attributable YPLL were estimated by multiplying sex- and age-specific SAM by remaining life expectancy at the time of death. The average annual YPLL estimates ranged from 7,762 (Alaska) to 481,529 (California). The YPLL estimates for males ranged from 4,586 (Alaska) to 288,823 (California), and from 3,176 (Alaska) to 192,706 (California) for females.
To reduce SAM rates further, the CDC said, comprehensive evidence-based approaches for preventing smoking initiation and increasing cessation need to be implemented fully, and states should fund tobacco control activities at the level recommended by CDC. The CDC's guide on tobacco control activities can be found on the Web at (www.cdc.gov/tobacco/tobacco_control_programs/stateandcommunity/best_practices