Continued Increases in the Relative Risk of Death From Smoking

An examination of the changes in relative risk of death among current and former smokers over recent decades in the United States found that the contribution of smoking to national mortality is not declining as quickly as might be expected, considering the decreasing national rate of smoking.

The authors linked data on adults aged 50-74 years at baseline from the National Health Interview Survey (NHIS) and the National Health and Nutrition Examination Survey (NHANES) to participants’ subsequent deaths, and calculated age-standardized death rates by smoking status and gender.

The relative risk of death for former and current smokers increased for both men and women. According to NHIS data, the risk of death for a smoker versus a never-smoker increased by 25.4 percent from 1987 to 2006, while the relative risk of death for smokers increased even more quickly according to NHANES data from 1971 to 2006. Former smokers also had an increasing relative risk of death, though a slower increase as compared to current smokers. These trends in death rates are independent of changes in the relationship between individual educational attainment and smoking status. Never-smokers had the largest proportionate decline in mortality rate.

Based on their findings, the authors suggest that well-known estimates of smoking-related deaths might be underestimated.