Decline in Smoking Averted Nearly 4 Million Lung Cancer Deaths in the US, Study Estimates
The number of lung cancer deaths averted represents more than 51% of the expected reduction in total cancer deaths, researchers reported.
Lead author Farhad Islami, MD, PhD
Image courtesy of the American Cancer Society
A new study led by American Cancer Society (ACS) researchers found that reductions in cigarette smoking from 1970 to 2022 may have averted an estimated 3.8 million lung cancer deaths in the US, with over 76 million person‐years of life (PYL) gained.1
“The substantial estimated numbers of averted lung cancer deaths and person-years of life gained highlight the remarkable effect of progress against smoking on reducing premature mortality from lung cancer,” lead author Farhad Islami, MD, PhD, senior scientific director, cancer disparity research, ACS, said in a press release.2 “However, despite these findings, lung cancer is still the leading cause of cancer death in the United States, and smoking-attributable morbidity and mortality from other cancers or diseases remain high.”
Using national mortality data and life‐expectancy estimates from the National Center for Health Statistics, Islami and his team compared observed lung cancer deaths to the number expected in the absence of declines in smoking prevalence between 1970 and 2022. The number of averted lung cancer deaths was calculated by subtracting the observed number of deaths from the expected number in each year, age, sex, race, and age group. Investigators estimated PYLs gained as a measure of avoided premature mortality based on the average additional years a person would have lived if they had not died from lung cancer. As mortality rates for all cancers combined have declined in recent decades, the researchers also estimated the proportions of averted all-cancer deaths that were attributable to the averted lung cancer burden.1
The results showed 3 856 240 lung cancer deaths (2 246 610 in men, 1 609 630 in women) were averted and 76 275 550 PYLs (40 277 690 in men, 35 997 860 in women) were gained, corresponding to an average gain of 19.8 PYL per averted death (17.9 PYL in men, 22.4 PYL in women.1
The analysis further revealed that averted lung cancer deaths accounted for 51.4% of the 7 504 040 all‐cancer deaths estimated to have been averted during the study period. This proportion was higher in men (60.1% of 3 738 520 averted all‐cancer deaths) than in women (42.7% of 3 765 510). Investigators also noted racial differences; among White individuals, lung cancer deaths averted represented 53.6% of all averted cancer deaths, compared with 40.0% in the Black population.1
A sensitivity analysis, which assumed no increases in lung cancer mortality beyond the observed peak rates, yielded lower estimates (approximately 2.2 million deaths averted and 43.9 million PYL gained), yet underscored the substantial impact of tobacco-control measures. The authors attributed these declines predominantly to sustained reductions in cigarette smoking following public health interventions initiated after the 1964 Surgeon General’s report.1
The findings highlight the significant public health benefit of tobacco control policies and suggest that continued efforts—such as increasing cigarette excise taxes and enhancing smoking cessation support—could further reduce the burden of lung cancer.1
“We need a stronger commitment at the local, state, and federal levels to help further reduce smoking and substantially augment the progress against smoking-related mortality,” Islami added in the press release.2 “It’s also important that these tobacco control programs be designed to reach groups at a higher risk of smoking, such as people of lower socioeconomic status, to help save even more lives. For example, smoking prevalence and lung cancer mortality rates in individuals with a high school diploma or lower education levels are 5 times higher compared with individuals with a college degree.”
For physicians, these data provide compelling evidence of the life-saving impact of smoking reduction strategies, reinforcing the critical importance of tobacco cessation interventions in clinical practice.1
References:
1. Islami F, Nargis N, Liu Q, et al. Averted lung cancer deaths due to reductions in cigarettesmoking in the United States, 1970–2022. CA Cancer J Clin. Published online March 25, 2025. doi:10.3322/caac.70005
2. ACS Study Finds Nearly Four Million Pre-mature Lung Cancer Deaths in U.S. Averted and 76 Million Years of Lives Gained Due to Tobacco Control. News release. American Cancer Society. March 25, 2025. Accessed March 27, 2025. https://pressroom.cancer.org/AvertedLungCancerDeaths
