Racial Disparities in Smoking-Attributable Mortality and Years of Potential Life Lost—Missouri, 2003–2007

November 26, 2010 / Vol. 59 / No. 46

MMWR Highlights

Smoking-Attributable Mortality (SAM)

• During 2003–2007, smoking caused an estimated average of 9,377 deaths annually among adults in Missouri.
  • 8,400 among whites
  • 853 among blacks
• An estimated 18.1% of deaths among persons aged ≥35 years in Missouri was the result of cigarette smoking (total number of deaths for this age group was 51,856).
• During 2003–2007 in Missouri, smoking caused
  • 32.1% of all deaths from cancer
  • 15.3% of all circulatory deaths
  • 46.5% of all respiratory deaths
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SAM Disparities

• The SAM rate in Missouri for blacks was 18% higher than for whites, and this disparity was larger for black men (28%) than for black women (11%).
• The SAM rates in Missouri for blacks were higher than for whites for malignant neoplasm and circulatory diseases but lower for respiratory diseases.
  • SAM rates for blacks were 26% higher than for whites for malignant neoplasm (e.g., cancers of the trachea, lung, or bronchus).
  • SAM rates for blacks were 53% higher than for whites for circulatory diseases (e.g., heart disease).
  • SAM rates for blacks were 32% lower than for whites for respiratory diseases (e.g., chronic airway obstruction).
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Years of Potential Life Lost (YPLL) Disparities

• The smoking-attributable YPLL rate for blacks was 18% higher than for whites.
• Black men had a YPLL rate 25% higher than white men.
• Black women had a YPLL rate 15% higher than white women.
• The YPLL rates for blacks were higher than for whites for malignant neoplasm and circulatory diseases but lower for respiratory diseases.
  • The YPLL rate resulting from smoking-related cancer deaths for blacks was 19% higher than for whites, and blacks had a 14% higher YPLL rate specifically for lung cancer.
  • For circulatory deaths, the YPLL rate for blacks was 54% higher than for whites, and blacks had a 35% higher YPPL rate specifically for ischemic heart disease.
  • For respiratory diseases, the YPLL rate for blacks was 33% lower than for whites, and blacks had a 38% lower rate specifically for chronic airway obstruction.

Factors Associated with Disparities

• The primary driver of SAM disparities is differences in the prevalence of smoking.
  • Although the smoking prevalence among blacks and whites in Missouri fluctuated during the past two decades, blacks tended to have a higher smoking prevalence than whites.
  • In 2009, the smoking prevalence was 27.1% among black adults and was 22.1% among white adults.
• Racial disparities in smoking-related morbidity and mortality may be associated with the following:
  • socioeconomic status
  • cigarette smoking patterns (e.g., amount and duration of smoking)
  • differences in biologic and genetic factors (e.g., nicotine metabolism)
  • differences in population demographics
  • geographic variations in tobacco control programs and policies
  • tobacco industry marketing strategies

Background

• The adult module of CDC's Smoking-Attributable Mortality, Morbidity, and Economic Costs (SAMMEC) system was used to calculate the SAM and YPLL rates for this report.