Volume 46 - Article 31 | Pages 905–918

The contribution of smoking-attributable mortality to differences in mortality and life expectancy among US African-American and white adults, 2000–2019

By Brian L. Rostron, Cindy M. Chang, Brittny C. Davis Lynn, Chunfeng Ren, Esther Salazar, Bridget K. Ambrose

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Date received:29 Jul 2021
Date published:12 May 2022
Word count:2472
Keywords:African Americans, disparities, life expectancy, mortality, smoking
DOI:10.4054/DemRes.2022.46.31
Additional files:Supplementary Material - Data and Calculations (Excel file, 199 kB)
 Supplementary Material - Life Tables (Excel file, 247 kB)
 

Abstract

Background: The role of smoking in racial disparities in mortality and life expectancy in the United States has been examined previously, but up-to-date estimates are generally unavailable, even though smoking prevalence has declined in recent decades.

Objective: We estimate the contribution of smoking-attributable mortality to observed differences in mortality and life expectancy for US African-American and white adults from 2000–2019.

Methods: The indirect Preston–Glei–Wilmoth method was used with national vital statistics and population data and nationally representative never-smoker lung cancer death rates to estimate the smoking-attributable fraction (SAF) of deaths in the United States by sex-race group from 2000–2019. Mortality rates without smoking-attributable mortality were used to estimate life expectancy at age 50 (e_50) by group during the period.

Results: African-American men had the highest estimated SAF during the period, beginning at 26.4% (95% CI:25.0%–27.8%) in 2000 and ending at 12.1% (95% CI:11.4%–12.8%) in 2019. The proportion of the difference in e_50 for white and African-American men that was due to smoking decreased from 27.7% to 14.8%. For African-American and white women, the estimated differences in e_50 without smoking-attributable mortality were similar to observed differences.

Conclusions: Smoking continues to contribute to racial disparities in mortality and life expectancy among men in the United States.

Contribution: We present updated estimates of the contribution of smoking to mortality differences in the United States using nationally representative data sources.

Author's Affiliation

Brian L. Rostron - US Food and Drug Administration, United States of America [Email]
Cindy M. Chang - US Food and Drug Administration, United States of America [Email]
Brittny C. Davis Lynn - US Food and Drug Administration, United States of America [Email]
Chunfeng Ren - US Food and Drug Administration, United States of America [Email]
Esther Salazar - US Food and Drug Administration, United States of America [Email]
Bridget K. Ambrose - US Food and Drug Administration, United States of America [Email]

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