Tobacco control programs and policies prevented more than 795,000 lung cancer deaths in the United States from 1975 through 2000, according to an analysis funded by the National Cancer Institute (NCI), part of the National Institutes of Health.

If all cigarette smoking in this country had ceased following the release of the first Surgeon General's report on smoking and health in 1964, a total of 2.5 million lung cancer-caused deaths would have been prevented in that time period.

“These findings provide a compelling illustration of the devastating impact of tobacco use in our nation and the enormous benefits of reducing rates of smoking,” said Robert Croyle, Ph.D., director of the Division of Cancer Control and Population Sciences at NCI. “Although great strides have been made, we cannot relax our efforts. The prevention and cessation of tobacco use continue to be vital priorities for the medical, scientific, and public health communities.”

The researchers estimated the impact of changes in smoking patterns resulting from tobacco control activities. Since the 1964 report, tobacco control efforts in the United States have included restrictions on smoking in public places, increases in cigarette excise taxes, limits on underage access to cigarettes, and efforts to increase public awareness of the hazards of smoking.

“This is the first attempt to quantify the impact of changes in smoking behaviors on lung cancer mortality based on detailed reconstruction of cigarette smoking histories,” said lead author Suresh Moolgavkar, M.D., Ph.D., of the Fred Hutchinson Cancer Research Center in Seattle. “The methods that were developed as a part of this research should prove to be invaluable to other researchers investigating the adverse health impacts of cigarette smoking.”

In the study, the researchers created three scenarios. In the first, called actual tobacco control, they used data on actual smoking behaviors of men and women in the United States. The second, called no tobacco control, predicted smoking behaviors that would have existed if no tobacco control policies were put in place. In the third, called complete tobacco control, the researchers examined the possible outcome if all smoking in the United States had ceased as of 1965, the first full year after the 1964 Surgeon General's Report on Smoking and Health was released.

The difference between lung cancer deaths in the no tobacco control scenario and the numbers of actual lung cancer deaths provided an estimate of the numbers of lung cancer deaths averted as a result of tobacco control activities. The researchers estimated that, without tobacco control programs and policies, an additional 552,000 men and 243,000 women would have died of lung cancer in the period from 1975 through 2000.

“An overwhelming majority of lung cancer deaths can be prevented by eliminating cigarette smoking,” said study author Eric Feuer, Ph.D., chief of NCI's Statistical Methodology and Applications Branch. “This finding indicates that, while great strides have been made in tobacco control – averting hundreds of thousands of lung cancer deaths in the United States – continued and enhanced efforts have the potential to avert even more deaths.”

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