Study Shows Fastest Decline in Lung Cancer Mortality Rates in California


California’s tobacco control programs have lowered lung cancer deaths 33% faster than the rest of the United States.

Lung cancer deaths are 28% lower in California compared with the rest of the United States and the gap continues to widen each year, according to a new study.

Lung cancer is the leading cause of cancer mortality among both men and women in the United States. An estimated 154,050 Americans are expected to die from lung cancer in 2018, accounting for approximately 25% of all cancer deaths, according to the American Lung Association.

The study, published in Cancer Prevention Research, analyzed smoking behavior from the National Health Interview Survey (1974-2014) and lung cancer data from the national Surveillance Epidemiology and End Results (SEER) Program (1970-2013). The authors examined survey responses on smoking behavior from a representative sampling of 962,174 US residents, with approximately 10% of respondents living in California. Lung cancer mortality rates were included from all death certificates filed in the 50 states and the District of Columbia and age-adjusted using the national SEER statistical database.

According to the findings, California showed much larger declines than the rest of the United States in smoking initiation and intensity, as well as increased quitting among those aged 18 to 35 years. Between 2012 and 2014, only 18.6% of individuals among this age group had ever smoked, smokers consumed only 6.3 cigarettes/d, and 45.7% of ever-smokers had quit by age 35. Overall, individuals under the age of 30 had a 39% lower initiation rate, 30% lower consumption of cigarettes among those who did smoke, and a 24% higher early quit rate.

Additionally, from 1985 to 2013, annual lung cancer mortality decreased 33% faster than the rest of the United States, which the authors cited as the largest decline ever seen in “what has been the biggest epidemic of our time.” By 2013, lung cancer deaths were 28% lower than the rest of the country.

The authors attributed the major reduction in cigarette smoking among those under the age of 35 years to California’s tobacco control efforts. From early on, California has taken an aggressive policy stance on reducing tobacco use and discouraging youth from starting to smoke with effective results, beginning with the country’s first comprehensive statewide tobacco control program run by the California Department of Public Health.

“Quitting smoking at any age will improve a person’s quality of life,” lead study author John P. Pierce, PhD, professor emeritus of cancer prevention at UC San Diego School of Medicine and Moores Cancer Center, said in a press release. “This can only be attributed to the success of tobacco control in this state which has been so effective in convincing young people not to smoke.”


Pierce JP, McMenamin SB, Benmarhnia T, et al. Trends in lung cancer and cigarette smoking: California compared to the rest of the United States. Cancer Prevention Research. 2018. Doi: 10.1158/1940-6207.CAPR-18-0341.

Lung Cancer Deaths are 28 Percent Lower in California [news release]. UC San Diego News Center’s website. Accessed October 10, 2018.

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