Wong Ryan, Matulewicz Richard S, Talwar Ruchika, Shoenbill Kimberly A, Goldstein Adam O, Bjurlin Marc A
Dr Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, Florida.
Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Urol Pract. 2025 Mar;12(2):250-256. doi: 10.1097/UPJ.0000000000000743. Epub 2024 Oct 25.
The temporal relationship between smoking exposure and bladder cancer (BC) diagnosis remains ill defined. This study aims to cross-correlate and temporally associate changes in US tobacco tax and consumption with BC incidence.
US tobacco consumption, tobacco tax data, and BC incidence rates from 1975 to 2019 were retrieved. A cross-correlation lag time for tobacco tax and consumption on BC incidence was calculated while controlling for national health expenditure. Proxied lag weighted semi-log linear models were used to determine the rate of change in BC incidence rates associated with a 1% change in tobacco tax percentages on a national and state level.
A 1% increase in tobacco tax was associated with a 1.77% decrease in BC incidence over a 6-year period ( = 0.9687, = .00044). Twenty-two states had a statistically significant decline in BC incidences correlated with increasing tobacco taxation. Reduction in BC incidence > 0.5% was observed in states along the western and eastern US borders. Montana, Utah, Nebraska, Arkansas, and Tennessee did not have decreasing BC incidences from tobacco tax increases. California had the most drastic decline in BC incidence (1.98%). Nationally, tobacco consumption decrease in 1 pack per capita was associated with a 0.47% decrease in BC incidence over a 28-year period ( = 0.984, = .00011).
Declining US tobacco consumption may indicate significant reduction in BC incidence through 2047. Primary prevention through adaptation of state-legislated tax changes may contribute to a reduction in BC incidence in states lying within the Central United States. A national tobacco tax initiative can be considered given the improvement in population health.
吸烟暴露与膀胱癌（BC）诊断之间的时间关系仍不明确。本研究旨在对美国烟草税和消费的变化与BC发病率进行交叉关联并建立时间上的联系。
检索了1975年至2019年美国的烟草消费、烟草税数据和BC发病率。在控制国家卫生支出的同时，计算了烟草税和消费对BC发病率的交叉关联滞后时间。使用代理滞后加权半对数线性模型来确定在国家和州层面上，烟草税百分比每变化1%时BC发病率的变化率。
烟草税增加1%与6年内BC发病率下降1.77%相关（ = 0.9687， = 0.00044）。22个州的BC发病率与烟草税增加呈统计学显著下降。在美国西部和东部边境的州，BC发病率下降超过0.5%。蒙大拿州、犹他州、内布拉斯加州、阿肯色州和田纳西州的BC发病率并未因烟草税增加而下降。加利福尼亚州的BC发病率下降最为显著（1.98%）。在全国范围内，人均烟草消费量减少1包与28年内BC发病率下降0.47%相关（ = 0.984， = 0.00011）。
美国烟草消费的下降可能表明到2047年BC发病率将大幅降低。通过调整州立法的税收变化进行一级预防可能有助于降低美国中部各州的BC发病率。考虑到人群健康的改善，可以考虑实施全国性的烟草税倡议。
