Suchergebnisse

Publication of the Surgeon General's Report in 1964 marshaled evidence of the harm to public health caused by cigarette smoking, including lung cancer mortality, and provided an impetus for introducing control programs. The purpose of this article is to develop estimates of their effect on basic smoking exposure input parameters related to introduction of the report. Fundamental inputs used to generate exposure to cigarettes are initiation and cessation rates for men and women, as well as the distribution of the number of cigarettes smoked per day. These fundamental quantities are presented for three scenarios: actual tobacco control in the United States; no tobacco control in which the experience before 1955 was assumed to continue; and complete tobacco control in which all smoking ceased following publication of the report. These results were derived using data from National Health Interview Surveys, and they provide basic input parameters for the Smoking History Generator used by each of the lung cancer models developed by the Cancer Intervention and Surveillance Modeling Network.

The age‐period‐cohort model is known to provide an excellent description of the temporal trends in lung cancer incidence and mortality. This analytic approach is extended to include the contribution of carcinogenesis models for smoking. Usefulness of this strategy is that it offers a way to temporally calibrate a model that is fitted to population data and it can be readily adopted for the consideration of many different models. In addition, it provides diagnostics that can suggest temporal limitations of a particular carcinogenesis model in describing population rates. Alternative carcinogenesis models can be embedded within this framework. The two‐stage clonal expansion model is implemented here. The model was used to estimate the impact of tobacco control after dissemination of knowledge of the harmful effects of cigarette smoking by comparing the observed number of lung cancer deaths to those expected if there had been no control compared to an ideal of complete control in 1965. Results indicate that 35.2% and 26.5% of lung cancer deaths that could have been avoided actually were for males and females, respectively.