Learning Objectives: Describe the correlation between state tobacco control efforts and state lung cancer death rates in young adults.
Abstract: OBJECTIVE: Trends in lung cancer occurrence among young adults reflect an early consequence of adolescent smoking and predict the future burden of tobacco-attributable cancers, given current tobacco control policies.
To demonstrate a relationship between an index of state tobacco control and lung cancer death rates in young adults.
METHODS: Ecological analysis correlating state-specific lung cancer death rates and trends in rates from 1980 – 1999 at ages 30 – 39 years with an index of state tobacco control efforts in 1992 – 1993. Age-adjusted lung cancer death rates among 30-39 year olds over four time intervals from 1980-84 through 1995-99. The annual percent change in the death rate within each state and group of states by tertile of tobacco control index was estimated by fitting a regression line to the logarithm of rates. We measured the correlation of an index of state tobacco control with absolute rates and with annual percent change.
RESULTS: Lung cancer death rates during the most recent time interval (1995-99) and the change in these rates over 20 years correlated strongly and inversely with the index of state tobacco control measured in 1992-1993. Lung cancer mortality decreased 4.01% per year in California but increased 2.54% per year in West Virginia.
DISCUSSION: Lung cancer death rates in young adults are lower and are decreasing faster in states with stronger tobacco control efforts. These measures may provide an early indication of local and regional progress in reducing tobacco-attributable disease.
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