Smoking-Related Deaths Down, but Nevada Leads U.S.

Nevada leads the nation in the rate of smoking-related deaths, while the Mormon Church’s prohibition against using tobacco keeps Utah relatively smoke-free. Overall, smoking-related deaths are declining.

These were some of the conclusions of the government’s first state-by-state look in five years at cigarette smoking, the single most preventable cause of premature death in the United States.

The Centers for Disease Control and Prevention analyzed deaths in 1990, and found that 20%, or 415,226, were caused by smoking. A 1988 estimate found that 434,000 people died from smoking-related causes.

Improvements in the emergency care of heart attacks and strokes and better treatment for cardiovascular diseases offset a slight increase in lung cancer deaths, said Mike Siegel, an epidemiologist in the CDC Office on Smoking and Health.

“Only a small percentage could be due to a drop in the smoking rate,” Siegel said.

The CDC looked at each state’s deaths from cancer, cardiovascular and respiratory conditions, infant diseases and burn deaths caused by smoking. The agency then used formulas based on the prevalence or percentage of adults who smoke, and on risks of health problems among current and ex-smokers, compared to nonsmokers.

Smoking took its heaviest toll in Nevada, where 24% of all deaths in 1990 were blamed on tobacco use. The CDC linked 2,234 Nevada deaths to smoking, for a smoking-related death rate of 478.1 per 100,000 people.

Nevada’s rates may be attributable in part to its large number of retirees; 80% of its residents were born elsewhere, said Willie Edwards, the Nevada Health Department’s first tobacco education and information officer.

Despite Nevada’s “live and let live” attitude, the state is responding to anti-smoking pressures from tourists, who want their casinos and restaurants smoke-free, Edwards said.

Pressure of another kind led to the nation’s lowest smoking-related death rate next door in Utah. Just 1,228 people died from smoking in 1990, 13.4% of the state’s total, for a mortality rate of 218 per 100,000 people.

Mormons account for 70% of Utah’s population, giving them a huge influence on smoking prevention, according to John Brockert, the state’s director of vital statistics.