Neighboring Western States Have Highest, Lowest Smoking-Attributable Mortality

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 Health.

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 population.)

"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 43[SS-1]:1-8, 1994).

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.