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Demography
Published in: Demography 2/2013

01-04-2013

The Contribution of Smoking to Black-White Differences in U.S. Mortality

Authors: Jessica Y. Ho, Irma T. Elo

Published in: Demography | Issue 2/2013

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Abstract

Smoking has significantly impacted American mortality and remains a major cause of morbidity and mortality. No previous study has systematically examined the contribution of smoking-attributable deaths to mortality trends among blacks or to black-white mortality differences at older ages over time in the United States. In this article, we employ multiple methods and data sources to provide a comprehensive assessment of this contribution. We find that smoking has contributed to the black-white gap in life expectancy at age 50 for males, accounting for 20 % to 48 % of the gap between 1980 and 2005, but not for females. The fraction of deaths attributable to smoking at ages above 50 is greater for black males than for white males; and among men, current smoking status explains about 20 % of the black excess relative risk in all-cause mortality at ages above 50 without adjustment for socioeconomic characteristics. These findings advance our understanding of the contribution of smoking to contemporary mortality trends and differences and reinforce the need for interventions that better address the needs of all groups.
previous article Estimation of Covariate Effects With Current Status Data and Differential Mortality
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Appendix
Available only for authorised users
Footnotes
1
These sites are the kidney, larynx, liver, lung, bone marrow, nasal cavity and paranasal sinuses, nasopharynx, oro- and hypopharynx, esophagus, oral cavity, pancreas, stomach, ureter, urinary bladder, and uterine cervix (IARC 2004).
 
2
Quit rates are calculated from a question asking respondents how long it had been since they last smoked regularly. The authors estimated a survival model using age at cessation as time of event and a base population of all ever-smokers in a given birth cohort/race/gender subgroup. Only respondents who had successfully quit at least two years prior to a survey were counted as having events in order to minimize the inclusion of failed quit attempts.
 
3
“Never-smokers” are defined as those who reported smoking less than 100 cigarettes in their lifetimes.
 
4
The median value in the open-ended category is estimated using the Pareto curve. The slope of this curve, v, is estimated as \( {{{\left[ {\log \left( {{n_t} + {n_{t - 1}}} \right) - \log \left( {{n_t}} \right)} \right]}} \left/ {{\left[ {\log \left( {{x_t}} \right) - \log \left( {{x_{t - 1}}} \right)} \right]}} \right.} \), where n t is the number of people in the open-ended (last) income category, n t – 1 is the number of people in the next-to-last income category, x t is the lower bound of the open-ended income category, and x t – 1 is the lower bound of the next-to-last income category. The median value for the open-ended category is then estimated as 10(0.301 / v) × x t .
 
5
(1.49 – 1.39) / (1.49 – 1.00) = .20.
 
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Metadata
Title
The Contribution of Smoking to Black-White Differences in U.S. Mortality
Authors
Jessica Y. Ho
Irma T. Elo
Publication date
01-04-2013
Publisher
Springer US
Published in
Demography / Issue 2/2013
Print ISSN: 0070-3370
Electronic ISSN: 1533-7790
DOI
https://doi.org/10.1007/s13524-012-0159-z

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