New statistics from the Centers for Disease Control and Prevention
(CDC) show Utah and Nevada (so close in proximity, so distant
in life-style) at the top and bottom, respectively, of a ranking
of states by smoking-related mortality (see table). The Center
hopes that release of the statistics will spur tobacco control
efforts, including higher state excise taxes on cigarettes.
In 1990, smoking accounted for more than 400,000 deaths nationwide,
say David E. Nelson, md, mph, and colleagues from the CDC's Office
on Smoking and Health, National Center for Chronic Disease Prevention
and Health Promotion. Yet state-specific data, which states can
use to document the magnitude of smoking-related health problems,
had not been compiled since 1985.
The new report provides state-specific cigarette smoking prevalence,
smoking-attributable mortality (SAM), and years of potential life
lost (YPLL) for 1990. The figures were estimated by using a special
software package--Smoking-Attributable Mortality, Morbidity, and
Economic Costs (SAMMEC)--developed by the Office on Smoking and
The median SAM rate was 363.3 per 100,000 population, ranging
from 218.0 in Utah to 478.1 in Nevada (see table). The median
percentage of all deaths attributable to smoking was 19.2% (range,
13.4% in Utah to 24.0% in Nevada).
The median estimate for YPLL was 66,959, with a range of 6,720
(Alaska) to 498,297 (California). (These two states also had the
fewest and most smoking-attributable deaths--402 for Alaska and
42,574 for California, a function of the size of each state's
"SAM rates tended to be higher in the southeastern states,
but all states continued to report substantial numbers of premature
deaths caused by cigarettes use," the researchers say (MMWR
The CDC researchers call for continued progress in reducing smoking
prevalence. "Although smoking prevalence has declined substantially
since the 1960s, about 20% of deaths in the United States can
be attributed to cigarette smoking," they say.