Estimation of Cigarette Smoking-Attributable Morbidity in the US

Internal Medicine World Report, October 2014,

The fact that cigarette smoking is dangerous to a person's health is not a new concept, but a recent study took a more direct view of just how much damage smokers in the United States do to themselves through what was described as "major medical conditions."

The fact that cigarette smoking is dangerous to a person’s health is not a new concept, but a recent study took a more direct view of just how much damage smokers in the United States do to themselves through what was described as “major medical conditions.”

Data for the study came from the US Census Bureau, the National Health Interview Survey, and the National Health and Nutrition Examination Survey. The estimates were then broken down based on sex, age, and smoking status, among other factors.

Observing the data, the authors said an estimated 6.9 million adults (95% CI, 6.5-7.4 million) that identified themselves as smokers combined for 10.9 million (95% CI, 10.-11.5 million) “smoking-attributable medical conditions.” Compared with estimates of chronic obstructive pulmonary disease (COPD) in the National Health and Nutrition Examination Survey, it was estimated that “US adults had had a combined 14.0 million (95% IC, 12.9-15.1 million) smoking-attributable conditions in 2009.”

“This figure is generally conservative owing to the existence of other diseases and medical events that were not included in these estimates,” they said. “Cigarette smoking remains a leading cause of preventable disease in the United States, underscoring the need for continuing and vigorous smoking-prevention efforts.”

In their report, the authors noted that in 2000, the US Centers for Disease Control and Prevention estimated 8.6 million Americans had reported 12.7 million conditions including chronic bronchitis, emphysema and COPD. They said that is the last time similar research had been done on the subject.

“The nature and magnitude of smoking-attributable morbidity has changed in the intervening years, and additional medical conditions have been linked to smoking,” they said.

The numbers released as part of the study explained that close to 48% of males and 45% of female smokers, 65-years-old or older, had at least one smoking-related condition. Of that group, 16.9% of men and 14.3% of women reported multiple conditions with diabetes being the most common for participants 35-years-old and older.

“The disease burden of cigarette smoking in the United States remains immense, and updated estimates indicate that COPD may be substantially underreported in health survey data,” the authors concluded.