State-Specific Smoking-Attributable Mortality and Years of Potential Life Lost—United States, 2000–2004

January 23, 2009 / Vol. 58 / No. 2

MMWR Highlights

Tobacco Use

• This report presents state-specific average annual smoking-attributable mortality and years of potential life lost estimates among adults aged > 35 years. The report compares 2000–2004 average annual smoking-attributable mortality rates per 100,000 with rates for 1996–1999.
• The analysis was based on data from CDC's Smoking-Attributable Mortality, Morbidity and Economic Costs (SAMMEC) system and shows that the median smoking-attributable mortality rate declined by 24.8 deaths per 100,000 from 1996–1999 (288 per 100,000) to 2000–2004 (263 per 100,000) and reflects progress made in lowering smoking prevalence.
• Declines in overall smoking-attributable mortality rates occurred in 49 states and the District of Columbia and reflects progress made in lowering smoking prevalence during the past 40 years.
• The average annual median estimate for years of potential life lost from 2000–2004 was 70,677 and ranged from 7,762 (Alaska) to 481,529 (California).
• Years of potential life lost estimates among males ranged from 4,586 (Alaska) to 288,823 California) and estimates among females ranged from 3,176 (Alaska) to 192,706 (California).
• The findings show a substantial variation in average annual smoking-attributable mortality during 2000–2004 among the states (range: 492 [Alaska] to 36,687 [California]).
• The overall average annual smoking-attributable mortality rates per 100,000 were lowest in Utah (138.3), Hawaii (167.6) and Minnesota (215.1) and highest in Kentucky (370.6), West Virginia (344.3) and Nevada (343.7).
• For every state, the annual number of smoking deaths was higher among males than females.
• Among males, smoking-attributable mortality estimates ranged from 314 in Alaska to 21,407 in California.
• For females, smoking-attributable mortality estimates ranged from 178 in Alaska to 15,280 in California.
• Changes in smoking-attributable deaths per 100,000 during these two periods varied among states: Nevada (-44.4), California (-37.8), and Virginia (-33.4), experienced the highest declines in smoking-attributable mortality rates among adults. Only one state, Oklahoma, experienced an increase (27 deaths per 100,000).
• Average annual smoking-attributable mortality rates overall decreased from 1996–1999 to 2000–2004 in all states except Oklahoma, and smoking-attributable mortality rates increased among women in Oklahoma, Mississippi, Kansas, South Dakota, Arizona, North Carolina, South Carolina, Georgia, Alabama, Tennessee, Kentucky, Texas, Arkansas, Ohio, Michigan, Indiana, Louisiana and District of Colombia.
• Burden of smoking-related deaths remains high and differences in the trends in smoking-attributable mortality rates by sex indicate more progress has been made over time in reducing the rate in men than in women. Between 1996–1999 and 2000–2004, rates declined in men in 49 states and the District of Columbia, but declined in women in only 32 states.
• Fully implementing effective state comprehensive tobacco-control programs, as recommended by CDC, can further reduce smoking prevalence and deaths caused by cigarette smoking in all states.