Tobacco control efforts have been successful at reducing the prevalence of smoking and its consequences for health, but there is still room for improvement, according to an analysis published in the Annals of Internal Medicine.1

Four simulation models were developed by research teams from Georgetown University, the University of Michigan, Yale University, and Massachusetts General Hospital with Harvard Medical School. Models included data from US adults ages 30 to 84 years, using trends in smoking from 1964 to 2015 and lung cancer mortality from 1969 to 2010 to predict trends from 2015 to 2065. Any influence of lung cancer screenings was not directly considered in this study.1

The models forecasted a reduction of 79% in age-adjusted lung cancer mortality for 2015 to 2065, using status quo trends. Also, the number of deaths from lung cancer per year is expected to drop to approximately 50,000 in 2065 from 135,000 in 2015.1

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However, 20 million adults in this age cohort are expected to be smokers in 2065, with 4.4 million lung cancer deaths expected from 2015 to 2065.1

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An editorial accompanying the report noted various demographic factors associated with disparities in smoking habits in the United States, including ethnicity, income, education, levels of psychological distress, and geography. By education level, there is 8 times as much use of tobacco among adults with a GED (41% prevalence) compared with adults holding a graduate degree (5% prevalence). Among states, 9% of Californians and 25% of West Virginians smoke.2

The study authors noted that current tobacco control methods are effective in reducing rates of smoking and concomitant lung cancer mortality, but that they should be supplemented by strategies to curtail smoking even further.1


1. Jeon J, Holford TR, Levy DT, et al. Smoking and lung cancer mortality in the United States from 2015 to 2065: a comparative modeling approach[published online October 9, 2018]. Ann Intern Med. doi: 10.7326/M18-1250

2. Silvestri GA, Carpenter MJ. Smoking trends and lung cancer mortality: the good, the bad, and the ugly[published online October 9, 2018]. Ann Intern Med. doi: 10.7326/M18-2775