T
he 2014 Surgeon General’s report
estimates that cigarette smoking causes
more than 480,000 deaths each year in
the United States.
1
This widely cited estimate of
the mortality burden of smoking may be an underestimate, because it considers deaths only
from the 21 diseases that have been formally
established as caused by smoking (12 types of
cancer, 6 categories of cardiovascular disease,
diabetes, chronic obstructive pulmonary disease
[COPD], and pneumonia including inf luenza).
Associations between smoking and the 30 most
common causes of death in the United Kingdom
in the Million Women Study suggest that the excess mortality observed among current smokers
cannot be fully explained by these 21 diseases.
2
We previously reported the risks associated
with smoking with respect to overall mortality and
five major causes of death (lung cancer, COPD,
ischemic heart disease, other heart disease, and
total [ischemic and hemorrhagic] stroke) in two
early American Cancer Society cohorts, as well as
in a contemporary population pooled from five
large U.S. cohorts.
3
We documented the ways in
which the smoking-related risk of death from
these causes has changed over the past 50 years,
but we did not examine mortality from other
causes. A full accounting of the mortality burden
from smoking in contemporary populations requires a comprehensive examination of the causes
of death.