Male Tobacco Smoke Load and Non-Lung Cancer Mortality Associations in Massachusetts

Purpose We assessed cumulative tobacco smoke cumulative damage (smoke load)/cancer mortality associations across time from 1979 to 2003 among Massachusetts males overall and at ages 30–74. Methods Annual lung cancer death rates were used as smoke load bio-indices, and lung/all other (non-lung) cancer death age-adjusted rate linear regressions were run for analysis to calculate smoking-attributable fractions (SAF). Death rate SAFs are equal to: 1- estimated unexposed rate/observed rate. Results Fairly steady all age and ages 30–74 years lung and non-lung cancer death rate declines occurred since 1992. Non-lung cancer death rates were tightly and steeply associated with smoke load across year. The slopes of those associations are 1.69 (95% confidence interval (CI) 1.35–2.04, r=0.90, or 1.36 (CI 1.02–1.96, r=0.95) when adjusted for possible autocorrelation) and 1.36 (CI 1.14–1.58, r=0.94) without detected autocorrelation (Durbin-Watson statistic = 1.8), respectively. The lung/non-lung cancer death rate associations suggest 2003 all-sites cancer death rate SAFs of 73% (SR 61–82%) at all ages and 74% (SR 61–82%) at ages 30–74. Conclusions The observed strong lung/non-lung cancer death rate associations suggest that tobacco smoke load may cause most prematurely fatal cancers at both lung and non-lung sites in Massachusetts male populations. Therefore, tobacco control may greatly reduce the overall cancer death rates.