Smoking Intensity and Mortality Across Age, Sex, and Race/Ethnicity Subgroups in the USA.

OBJECTIVE

To determine whether standardized mortality ratios (SMRs) for smoking vary with age, sex, and race/ethnicity differences in smoking intensity.

METHODS

SMRs for current smoking were computed based on data of adult participants in the National Health Interview Surveys 2000-2003 separately by sex-age and sex-race/ethnicity subgroups. Mortality follow-up was through 2018.

RESULTS

SMRs across sex-age subgroups were highest for men aged 50-59 years (SMR 3.22) and lowest for men aged 80 years or older (SMR 1.10). Variations in SMRs across sex-age subgroups were directly correlated with group differences in median daily cigarette use (Spearman r = 0.70). Across sex-race/ethnicity subgroups, the SMR was highest among White men (SMR 2.39) and lowest among Hispanic men (SMR 1.26) and was again directly correlated with median daily cigarette use (Spearman r = 0.79).

CONCLUSIONS

SMRs for smoking are not singular estimates but rather vary widely with demographic-related differences in smoking intensity. In resource-constrained settings, smoking reduction interventions that target subgroups with higher smoking intensity may be more efficient in reducing smoking-related mortality.