Estimating Smoking-Attributable Mortality in the United States

Andrew Fenelon, Samuel H. Preston

Research output: Contribution to journalArticlepeer-review

75 Scopus citations


Tobacco use is the largest single cause of premature death in the developed world. Two methods of estimating the number of deaths attributable to smoking use mortality from lung cancer as an indicator of the damage from smoking. We reestimate the coefficients of one of these, the Preston/Glei/Wilmoth model, using recent data from U. S. states. We calculate smoking-attributable fractions for the 50 states and the United States as a whole in 2004, and estimate the contribution of smoking to the high adult mortality of the southern states. We estimate that 21% of deaths among men and 17% among women were attributable to smoking in 2004. Across states, attributable fractions range from 11% to 30% among men and from 7% to 23% among women. Smoking-related mortality also explains as much as 60% of the mortality disadvantage of southern states compared with other regions. At the national level, our estimates are in close agreement with those of the Centers for Disease Control and Prevention and Preston/Glei/Wilmoth, particularly for men, although we find greater variability by state than does CDC. We suggest that our coefficients are suitable for calculating smoking-attributable mortality in contexts with relatively mature epidemics of cigarette smoking.

Original languageEnglish (US)
Pages (from-to)797-818
Number of pages22
Issue number3
StatePublished - Aug 2012
Externally publishedYes

Bibliographical note

Funding Information:
This research was supported by National Institutes of Health fellowship 1-F31-AG-039188-01, and Grant from Social Security Administration and National Bureau of Economic Research. We are grateful to Andrew Noymer and Douglas Ewbank for comments and critiques. An earlier version of this paper was presented at the annual meeting of the Population Association of America in Dallas, TX, April 15–17, 2010.


  • Cigarette smoking
  • Geographic variation
  • Method
  • Mortality
  • United States


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