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Tobacco and Excess Death: An Interesting Combination


Excess death or excess mortality is defined as by the free medical dictionary is “a premature death, or one that occurs before the average life expectancy for a person of a particular demographic category.”  

Smoking is one of the major causes of excess death.  There is lots of debate about smokers rights, government intrusion into private lives, and reduction of government spending these days.  Here are some thoughts on government backed efforts to encourage and help citizens quit smoking.  This is on my mind today because  my Mom died this week of a smoking related illness, throat cancer, and I was looking for any good news about smoking cessation programs or population based success stories.

This week the MMR put out its press release outlining a program in Minnesota from 1999-2010.  Over that period of time Minnesota maintained a sustained effort to reduce cigarette smoking, and has some degree of success.  Tobacco addiction is a terrible problem in the US, and increasingly worldwide.

In Minnesota over this period of time they instituted provision of statewide smoking cessation programs, a comprehensive smoke-free law, increased tobacco taxes and had mass media campaigns.  During this time Minnesota outperformed the rest of the US by having the prevalence of tobacco use in adults drop from 22.1% in 1999 to 16.1% in 2010, a 27% drop, compared to very modest reductions nationwide. (1)

This may seem modest, but Minnesota is a fairly large state with a population of 5.27 million, and an estimated 3.87 million adults. This means about 231,900 less Minnesota adults smoke now than smoked in 1999.  I had a hard time coming up with data to estimate the number of life years saved by this campaign, but if the smokers who quit reflect the demographics of the adult population in MI and using the excess death data from 2004 BMJ British physician study (really a rough estimate I know) then about 2,085,000 life years were extended to the citizens of Minnesota as a result of quitting smoking in this time frame.

If the entire US replicated this program, and had smoking cessation rates that match those in MI then by extrapolation we could add about 122 million years to the lives of Americans over a 10 year period if 6% less Americans smoked after the program.

When I think if the dollars spent to add a year of life by many medical interventions, this type of program seems like it would be a bargain.  One study suggests that for every $1.00 spent on tobacco cessation a state saves $1.26 in lost revenue from work missed and tax revenue.  If that’s true then states can actually improve their bottom line while they improve the health of their citizens.  Sounds pretty good to me.  This medical blog loves comments, let me know what you think.


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