Population Research and Policy Review 17: 285–304, 1998.
1998 Kluwer Academic Publishers. Printed in the Netherlands.
Adult mortality differentials associated with cigarette smoking
in the USA
ROBERT A. HUMMER
, CHARLES B. NAM
RICHARD G. ROGERS
Population Research Center and Department of Sociology, University of Texas-Austin;
Center for the Study of Population, Florida State University;
Population Program and
Department of Sociology, University of Colorado-Boulder, Colorado, USA
Abstract. Although cigarette smoking has been extensively researched, surprising little knowl-
edge has been produced by demographers using demographic perspectives and techniques.
Thus, this paper contributes to the literature by extending a demographic framework to an
important behavior for mortality research: cigarette smoking. In earlier works, the authors
used nationally-representative data to show that cause of death patterns varied by smoking
status and that multiple causes of death characterized smokers moreso than non-smokers. The
present work extends previous analysis by estimating smoking status mortality differentials
by underlying and multiple causes of death and by age and sex. Data from the 1986 National
Mortality Followback Survey are related to data from the 1985 and 1987 National Health Inter-
view Survey supplements to assess the smoking-related mortality differentials. We ﬁnd that
cigarette smoking is associated with higher mortality for all population categories studied, that
the smoking mortality differentials vary across the different smoking status categories and by
demographic group, and that the mortality differentials vary according to whether underlying
cause or multiple cause patterns of death are examined. Moreover, the multiple cause analysis
highlights otherwise obscured smoking-mortality relations and points to the importance of
respiratory diseases and cancers other than lung cancer for cigarette smoking research.
Key words: Cigarette smoking, Mortality differentials, Underlying cause, Multiple cause
Cigarette smoking is a critical behavioral factor that is associatedwith mortal-
ity and life expectancy (Benjamin 1982; Centers for Disease Control [CDC]
1993; Lopez 1990; Ravenholt 1990; Nam, et al. 1994; Rogers & Powell-
Griner 1991). Recent estimates, for example, suggest that nearly 20% of all
US deaths, or about 425,000 per year, are associated with smoking (CDC
1993; Mosley & Cowley 1991). In addition, smokers exhibit excess mortality
fromcertain causes of death compared to non-smokers. Thesenot only include
lung cancer and other respiratory cancers, but also circulatory diseases, other
forms of cancer, accidents, and other causes ranging from diabetes to cir-
rhosis of the liver (CDC 1989; Ernster 1993; Lopez 1990; Ravenholt 1990).